Fenfluramine Therapy in Non-insulin-dependent Diabetic Patients: Effects on Body Weight, Glucose Homeostasis, Serum Lipoproteins, and Antipyrine Metabolism

The usefulness of fenfluramine (F), in association with diet therapy, was investigated in 13 obese noninsulin- dependent diabetic patients with poor diabetes control on a previous sulfonylurea regimen (SU). A double-blind crossover comparison of F and placebo (P) consisted of two 7-wk treatment periods. F was administered in stepwise increased and subsequently reduced doses, while the doses of SU were kept unchanged. There was a significant weight loss in F-treated obese subjects as compared with treatment by P. The fasting levels, and particularly the postprandial blood glucose (BG) levels, were significantly lower during F than during P administration. Serum fasting insulin and blood lactate concentrations remained unchanged during the trial. Serum triglycerides and cholesterol decreased during F administration. HDL-cholesterol and apoprotein A-I increased slightly, while apoprotein B decreased during F, but not during P administration. The effect of fenfluramine on hepatic drug metabolism was assessed by using the antipyrine test. F did not cause significant changes in antipyrine metabolism. Fenfluramine therefore seems to be useful as an adjunct to diet and SU therapy in obese non-insulin-dependent diabetic patients.

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