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GPs should use obesity drugs longer in diabetes

GPs should trial obesity drugs in patients with diabetes longer than recommended before deciding if they are working, a study concludes.

NICE guidance advises that patients should only be continued on the drugs if they have lost at least 2kg after four weeks, but the researchers found this would deny beneficial treatment to a significant proportion of patients.

The study, which pooled data from seven trials of sibutra-mine, found assessment at four weeks predicted ultimate weight loss with a sensitivity of just 61 per cent and a specificity of 68 per cent. But assessing patients who had lost 4kg at three months increased sensitivity to 79 per cent and specificity to 77 per cent.

Study leader Dr Nick Finer, consultant in obesity medicine at Addenbrooke's Hospital, Cam- bridge, said: 'My advice is that patients with diabetes need to be on sibutramine for longer before you decide they have failed.

'I don't want to tell GPs to breach NICE guidance but the problem with guidelines is they can go out of date.'

Dr Finer, whose study is published in Diabetes, Obesity and Metabolism (March), said the findings were also likely to apply to orlistat.

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