The results of a recent clinical trial, published in the journal The Lancet, show that a weight loss drug may prevent and treat diabetes.

More than 30 million people, or 9% of the population of the United States, are living with diabetes, explain the Centers for Disease Control and Prevention (CDC).

Overall, more than 100 million US adults, or a third of the adult population, now have either diabetes or prediabetes, report the CDC.

The current treatment options include oral drugs such as metformin, various forms of insulin, and interventions such as weight loss surgery.

New research recently presented at the 2018 Meeting of the European Association for the Study of Diabetes, held in Berlin, Germany, makes a new addition to this treatment arsenal.

The weight loss drug lorcaserin was shown to reduce the risk of diabetes complications, induce diabetes remission, and lower the risk of developing the condition in a clinical trial led by researchers from the Brigham and Women's Hospital (BWH) in Boston, MA.

BWH scientists from the Thrombolysis in Myocardial Infarction (TIMI) Study Group conducted the trial, and the findings they presented were from the CAMELLIA-TIMI 61 clinical trial. Eisai Inc, the company that manufactures the drug, funded the trial.

Dr. Erin Bohula, a BWH cardiovascular medicine specialist and a staff investigator for the TIMI Study Group, co-led the research together with Dr. Benjamin Scirica, also a cardiovascular medicine specialist at BWH and senior investigator for the TIMI Study Group.

How lorcaserin affects diabetes, prediabetes

The CAMELLIA-TIMI 61 trial included 12,000 people who were either overweight or obese and were at risk of developing cardiovascular disease. Additionally, over half of the participants had diabetes and a third had prediabetes.

Half of the participants were allocated to receive the weight loss drug, while the other half received placebo. The researchers monitored the participants for an average period of over 3 years.

The trial revealed the following:

• Lorcaserin reduced diabetes risk by 19% among those who already had prediabetes. So, 172 people out of 2,015 who took lorcaserin and had prediabetes went on to develop diabetes, whereas 204 people out of 1,976 who had prediabetes, but took only the placebo, developed diabetes.
• As many as 9.2% of people with prediabetes who took lorcaserin restored their blood sugar levels back to normal, compared with 7.6% in the placebo group.
• Also, 7.1% of the people who had diabetes and took the drug had significant remission in their hyperglycemia, compared with 6% of patients who took the placebo.
• The drug also lowered the risk of complications from diabetes, such as microalbuminuria, diabetic retinopathy, and diabetic neuropathy, by 21%.

However, the study authors also report that lorcaserin significantly increased the number of severe cases of hypoglycemia among people who were already taking insulin or other treatments for diabetes known to raise the risk of hypoglycemia.

"We recently presented findings showing that use of lorcaserin resulted in modest but sustained weight loss among obese and overweight patients without increasing risk of heart attack and stroke," explains Dr. Bohula.

In this trial, the drug resulted in a weight loss of 4.2 kilograms, on average, compared with 1.4 kilograms in the placebo group.

"Now we [also] report that, when added to lifestyle interventions, lorcaserin significantly reduced incidence of diabetes, increased rates of diabetes remission, and reduced the risk of diabetic microvascular complications."

–Dr. Erin Bohula

Dr. Scirica also comments on the recent findings, saying, "Taken together, these findings reinforce the notion that modest, durable weight loss can improve cardiometabolic health and supports the role of lorcaserin as an adjunctive therapy in chronic weight management."

"It provides another tool in the armamentarium, beyond diet and exercise, for patients hoping to achieve and maintain weight loss."

"And, happily, as we saw, even relatively modest weight loss can improve the diabetes control in those with diabetes and reduce the development of diabetes in those at risk," Dr. Scirica says.

"Given the global prevalence of obesity and its association with type 2 diabetes and complications that can cause death or greatly diminish quality of life, we need therapeutic strategies that can be added to lifestyle modification to prevent and control diabetes," he adds.

"This rigorous and large-scale randomized study demonstrates the potential for improving glycemic control when adding a weight loss agent to a treatment plan."