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World J Diabetes. Mar 15, 2010; 1(1): 8-11
Published online Mar 15, 2010. doi: 10.4239/wjd.v1.i1.8
Combination drug treatment in obese diabetic patients
Theodosios D Filippatos, Moses S Elisaf
Theodosios D Filippatos, Moses S Elisaf, Department of Internal Medicine, University of Ioannina, Ioannina 45110, Greece
Author contributions: Filippatos TD prepared and wrote the editorial; Elisaf MS made corrections and did the final editing of the manuscript.
Correspondence to: Moses S Elisaf, MD, FRSH, FASA, FISA, Professor of Medicine, Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina 45110, Greece.
Telephone: +30-2651-007509 Fax: +30-2651-007016
Received: October 9, 2009
Revised: February 20, 2010
Accepted: February 27, 2010
Published online: March 15, 2010

Drug combinations that include antiobesity drugs (such as orlistat and sibutramine) and target cardiovascular disease (CVD) risk factors may be a good approach to patients with type 2 diabetes and/or metabolic syndrome (MetS). Our group has investigated the orlistat-fenofibrate combination treatment in obese patients with MetS and the orlistat-ezetimibe and the sibutramine-antihypertensive combination treatment in obese patients with hyperlipidaemia with promising results in CVD risk factor reduction. In these studies, the combination treatment significantly improved the lipid and lipoprotein profile, the carbohydrate metabolism parameters and many other variables playing a role in the atherosclerotic process. Small studies give promising results but double-blind, randomized trials examining the effects of such multifactorial treatment in hard CVD endpoints in diabetic or MetS patients are missing.

Keywords: Diabetes, Metabolic syndrome, Orlistat, Sibutramine, Fenofibrate, Ezetimibe, Weight loss