USEFULNESS OF FLUOXETINE IN OBESE NON-INSULIN-DEPENDENT DIABETICS - AMULTICENTER STUDY

Weight reduction is essential in the management of most noninsulin-dep endent diabetics, but this therapeutical goal is difficult to obtain. In this double-blind parallel study, 82 noninsulin-dependent diabetics , moderately obese (BMI = 30 - 39 kg/m(2)), were given for an 8-week p eriod either placebo (P) or fluoxetine (F), a specific serotonin reupt ake inhibitor, in addition to their usual antidiabetic treatment. Thir ty-nine of them received 60 mg fluoxetine a day and 43 were given the placebo. At admission, both groups had similar weight excess, metaboli c control and serum lipid values. In comparison with the P-treated sub jects, those treated with fluoxetine (F) lost more weight after 3 week s (-1.9 vs. -0.7 kg, p<0.0009) and after 8 weeks (-3.1 vs. -0.9 kg, p< 0.0007). Easting blood glucose decreased in group F after 3 weeks (-1. 5 vs. -0.4 mmol/L, p<0.003) and after 8 weeks (-1.7 vs. -0.02 mmol/L, p<0.0004). HbAlc decreased from 8.5% to 7.7% in group F and from 8.6% to 8.3% in group P (p=0.057). Mean triglyceride level was also reduced in group F after 8 weeks (p=0.042). Easting C-peptide did not change in either group, but fasting insulin values decreased in group F after 3 weeks (p<0.02) and after 8 weeks (p<0.05). The insulin/C-peptide mo lar ratio decreased significantly in group F after 3 weeks (p<0.04) an d after 8 weeks (p<0.05) in comparison with group P. The drug was gene rally well tolerated and no major side effects were reported. In concl usion, the addition of fluoxetine to the usual oral hypoglycemic agent therapy might be beneficial in obese non-insulin-dependent diabetics, at least on a short-term basis.