More Hyperinsulinemia, Insulin-Suppressive Drugs & Obesity (and Lustig)

Building on my last post on this topic ...

So far I've spent most of the blogging on a study comparing 3 doses of octreotide, an insulin suppressing drug, vs. placebo in a subset of obese people pre-tested and determined to be insulin hypersecreters as defined by a corrected ratio for insulin to glucose levels.  This post will focus more on two other studies using this drug, perhaps just the first ... let's see how long this gets ;-)    I think it will be easiest to number the 3 studies, all bearing Lustig's name:

• Study 1: Suppression of insulin secretion is associated with weight loss and altered macronutrient intake and preference in a subset of obese adults (2003)
• Study 2: Obesity, leptin resistance, and the effects of insulin reduction  (2004)
• Study 3: A multicenter, randomized, double-blind, placebo-controlled, dose-finding trial of a long-acting formulation of octreotide in promoting weight loss in obese adults with insulin hypersecretion.  (2006)

I've already discussed the rather unimpressive performance of octreotide in Study 3.  While the highest dose group had the highest "response" rate (20.5% losing ≥5% initial weight), the rates were similar between the placebo group (11.4%) compared to the 40mg octreotide group (12.5%), which is important as this is the dose used in Studies 1&2.   Additionally, mean losses for the entire 40 & 60 mg groups were less than 2%, and even the most promising responders, Caucasian hypersecreters with above median CIR, only lost an average of less than 4% over 6 months.

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