Barry R.
Age 46
Height 5'10"
Weight 200 lbs
Fasting Insulin
202 pmol/L
HbA_1c 8.5%
Lipid Profile:
TG 150 mg/dL
HDL 38 mg/dL
LDL 148 mg/dL
LDL/HDL ratio 3.9
TC 216 mg/dL

Previous Patient Profile

• Profile and History
• Diagnosis and Identification
• Counseling
• Treatment
• Follow-Up
• Outcomes

Profile and History:
Barry R., a 46-year-old African American college instructor, has type 2 diabetes, as well as dyslipidemia. You've been monitoring his blood sugar and lipids on a fairly regular basis. He's taking:

• Metformin, 1000 mg bid
• Glipizide extended-release, 10 mg/day, for his diabetes
• Simvastatin, 10 mg/day, for dyslipidemia

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Diagnosis and Identification:

• Barry is 5'10", weighs 200 lbs and has a BMI of 29.
• His test results confirm your suspicions about his diet. His blood sugar is not under sufficient control (he has a fasting insulin level of 202 pmol/L and an HbA_1c of 8.5%), and his lipid profile is not as good as it could be (TG 150 mg/dL, HDL 38 mg/dL, LDL 148 mg/dL, LDL/HDL ratio 3.9, TC 216 mg/dL).
• Barry's results suggest that a low-calorie, structured diet plan and a prescription for XENICAL would be appropriate to lower his weight in order to improve his lipid profile and HbA_1c.
• He should also be encouraged to resume regular activity.

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Counseling:
During the patient counseling session, Barry seems open and receptive to your concerns about his health. He acknowledges that his weight is up and that he must change his dietary and exercise habits.

• He further admits that he has opportunities to exercise but doesn't pursue them; for example, he could be walking the eight blocks to school instead of taking the bus.
• He understands that if he doesn't change these lifestyle habits, his disease profile could become much worse.

More on counseling your patient

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Treatment:

• Your treatment goals for Barry include weight loss, improved glycemic control to avoid complications, improved dyslipidemic profile and reduced cardiovascular risk.
• A regimen including a prescription for XENICAL, increased activity levels and a 1200-calorie per day diet is advisable.
• By recommending that he enroll immediately in the XENICare^® support program, you ensure greater compliance.
• With the results you're looking for, you may be able to reduce some of his other current medication as well.

More on treatment and management

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Follow-Up:

• Barry returns to your office in a month. Although he hasn't gained any weight, he hasn't lost any either. Barry may benefit from a reminder about enrolling in XENICare^®, the free patient support program described in the XENICAL Patient Starter Kit.
• At a subsequent office visit, Barry's examination reveals a loss of 9 lbs and that he is making progress towards achieving the treatment goals.

More on follow-up care

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Outcomes:
Population with Abnormal (Untreated) Risk Factors at Randomization

Weight Loss with XENICAL Plus Diet: Improved Fasting Insulin and Lipid Levels

• In patients with abnormal baseline values of fasting insulin
  (>120 pmol/L), weight loss with XENICAL plus diet resulted in a greater decrease in fasting insulin than did placebo (-39 pmol/L vs. -16 pmol/L, respectively) from randomization to 1 year.
• The changes from randomization following 1-year treatment in the population with abnormal lipid levels (LDL >130 mg/dL, LDL/HDL >3.5, HDL <35 mg/dL) were greater for patients on XENICAL plus diet compared to patients on placebo plus diet with respect to LDL cholesterol (-7.83% vs. +1.14%) and the LDL/HDL ratio (-0.64 vs. 0.46). HDL cholesterol increased in the placebo group by 20.1% and in the XENICAL group by 18.8%.

Population as a Whole

XENICAL Plus Diet: Successful Weight Loss
In clinical trials involving 1064 patients, 69% on XENICAL plus diet lost 3% or more of initial body weight within 3 months, with a mean loss of 13 lbs.¹⁸

The mean change in fasting insulin was -6.7 pmol/L for patients on XENICAL plus diet and +5.2 pmol/L for patients on placebo plus diet. The mean change in total cholesterol was -2.0% for patients on XENICAL plus diet and +5.0% for patients on placebo plus diet. The mean change in LDL cholesterol was -4.0% for patients on XENICAL plus diet and +5.0% for patients on placebo plus diet. The mean change in HDL cholesterol was +9.3% for patients on XENICAL plus diet and +12.8% for patients on placebo plus diet.

In clinical trials, the overall mean weight loss from randomization to the end of 1 year in the intent-to-treat population was 13.4 lbs in patients treated with XENICAL plus diet versus 5.8 lbs in placebo-treated patients.

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The long-term effects of orlistat on morbidity and mortality associated with obesity have not been established.

The patient depicted here is fictitious and is intended to illustrate an obesity-related comorbidity for which a treatment regimen including XENICAL plus a reduced-calorie diet is appropriate.

Previous Patient Profile