WASHINGTON — Colesevelam (WelChol), approved in the United States since 2000 for lowering lipid levels, also appears to reduce postprandial glucose in patients with type 2 diabetes, Dr. Franklin Zieve and his associates reported in a poster at the annual scientific sessions of the American Diabetes Association.
The incidental observation prompted Daiichi Sankyo Inc. to sponsor a prospective study of the glucose-lowering effects of its bile acid sequestrant drug, Dr. Zieve of the Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Va., told this newspaper at the meeting.
A total of 65 patients with type 2 diabetes with hemoglobin A1c levels of 7.0% or above were randomized to receive 3.75 g/day of colesevelam (6 tablets/day) or placebo for 12 weeks, following a 4-week placebo run-in period. Patients continued taking their existing antidiabetic medications. Thirty-two colesevelam and 27 placebo subjects completed the trial.
At 12 weeks, mean postprandial glucose levels were reduced by a significant 18 mg/dL (from 269 to 251) in the colesevelam group, compared with an insignificant gain of 3 mg/dL (285 to 288) in the placebo group. Hemoglobin A1c levels dropped by approximately 0.3 percentage points from baseline with colesevelam, resulting in a 0.5 percentage-point difference from placebo at 12 weeks.