the effect of topiramate on weight loss in patients with type 2 diabetes

background: obesity has been associated with several co ‑ morbidities such as diabetes and increased mortality. in general, the use of medication promotes only a modest weight loss in the range of 2 to 10 kg, usually most effective during the first 6 months of therapy; however, studies have shown positive effects on other risk factors such as blood pressure and serum glucose levels, but there are fewer studies in patients with diabetes. the aim of this study was to assess the effect of topiramate on weight reduction patients with type 2 diabetes. materials and methods: this was a 32 ‑ week randomized clinical trial study of 69 subjects during 2008 ‑ 2010. patients, in two treatment groups were given topiramate (39 patients) and placebo (30 patients) and were subjected to participation in a non ‑ pharmacologic lifestyle intervention program; which were randomly allocated in our two groups. the percentage change in body weight and body mass index (bmi) at the end of the study was the primary efficacy endpoint and secondary indicators were changes in blood pressure (bp), proportion of subjects who achieved 5% or 10% weight loss, changes in lipid profile (total cholesterol, low ‑ density lipoprotein cholesterol, high ‑ density lipoprotein cholesterol, triglycerides); and changes in glycosylated hemoglobin (hga1c). paired samples and independent samples t ‑ test was used for statistical analysis. (rct code: irct201112036027n2). results: all results were extracted on base of 69 (intended to treat) itt patients. mean bmi changes was significantly higher in patients treated with topiramate ( ‑ 1.08 1.90 vs. + 0.086 ± 1.05 kg/m2, p = 0.006). mean weight loss percentage was significantly different between active and placebo groups ( ‑ 3.02 ± 5.78% vs. + 0.32 ± 3.54%, p = 0.005) and systolic blood pressure and hga1c significantly decreased in patients treated with topiramate ( p = 0.021 and p = 0.047, respectively). conclusion: topiramate induced weight loss and improved glycemic control in obese, diabetic patients.