News & Research

Weight loss and metabolic effects of topiramate in overweight and obese type 2 diabetic patients: randomized double-blind placebo-controlled trial, by B. Eliasson and colleagues. Int J Obes 31:1140-1147, 2007

What is the problem and what is known about it so far?

People with diabetes often need medication to keep blood glucose closer to normal levels. People with diabetes who are overweight or obese and may benefit from a drug that could help them lose weight. There are few drugs that improve glucose control and help people lose weight. Additional drugs that are safe and effective would increase options for overweight and obese people with type 2 diabetes.

Why did the researchers do this particular study?

Researchers wanted to study the effects of topiramate, a drug approved to treat seizures, on the metabolism of overweight and obese people with type 2 diabetes.

Topiramate is also sometimes given to treat the symptoms of peripheral neuropathy, a nerve disorder that is a common complication of diabetes. Some research suggests that topiramate may improve the body?s ability to handle insulin and glucose.

Who was studied?

The study included 38 people in Sweden. All of the participants were overweight or obese, had diabetes, and were treated with diet or the diabetes drug sulfonylurea.

How was the study done?

Participants had a physical exam and blood tests to measure how well their body handles insulin and glucose. Half of the participants were selected to take 96 mg of topiramate twice a day, while the other half took a placebo (a pill that has no effect). They were treated for 11 months while following a planned diet.

What did the researchers find?

People who took topiramate showed improved function of insulin and glucose, including lower levels of A1C, a measure of long-term glucose control. People on topiramate therapy also tended to lose more weight and had a leaner body mass.

What were the limitations of the study?

The number of participants was fairly small. There could have been differences in diets or other health habits not studied that could have influenced the findings.

What are the implications of the study?

Topiramate may help overweight and obese people with diabetes lose weight and improve their ability to handle insulin and glucose. More studies need to be done on the use topiramate to help people with diabetes lose weight. As with all medicines, patients should only take topiramate if it is prescribed by their treating physicians.