Suppression of Insulin Secretion in the Treatment of Obesity: A Systematic Review and Meta-Analysis

Objective This proof-of-concept study aimed to evaluate the efficacy and safety of suppression of insulin secretion in the treatment of obesity. Methods A search of PubMed, Embase, and Cochrane databases was performed to identify randomized controlled trials (up to January 1, 2020) that used drugs that directly suppress insulin secretion (diazoxide or octreotide) in the treatment of obesity. The extracted data were analyzed using random-effects meta-analysis. Results A total of seven randomized controlled trials were included, with four using diazoxide and three using octreotide to suppress insulin secretion. Suppression of insulin secretion significantly reduced fasting insulin level (mean difference: -3.94 mIU/L; 95% CI: -7.40 to -0.47) but slightly increased fasting blood glucose level (mean difference: 0.48 mmol/L; 95% CI: 0.24 to 0.72). Following the suppression of insulin secretion, significant reductions in body weight (mean difference: -3.19 kg; 95% CI: -5.71 to -0.66), BMI (mean difference: -1.65 kg/m(2); 95% CI: -2.41 to -0.90), and fat mass (mean difference: -5.92 kg; 95% CI: -8.28 to -3.56) were observed compared with placebo in the pooled data. No significant difference in fat-free mass was observed (mean difference: 0.56 kg; 95% CI: -0.40 to 1.52). Conclusions Results suggest that suppression of insulin secretion may lead to reduced body weight and fat mass with slightly increased blood glucose in individuals with obesity.