|Reference : The addition of glipizide to insulin therapy in type-II diabetic patients with secondary...|
|Scientific journals : Article|
|Human health sciences : Pharmacy, pharmacology & toxicology|
Human health sciences : Endocrinology, metabolism & nutrition
|The addition of glipizide to insulin therapy in type-II diabetic patients with secondary failure to sulfonylureas is useful only in the presence of a significant residual insulin secretion.|
|Castillo, M. [> > > >]|
|Scheen, André [Université de Liège - ULg > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale >]|
|Paolisso, G. [> > > >]|
|Lefebvre, Pierre [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]|
|[en] Adult ; Blood Glucose/analysis ; C-Peptide/blood ; Clinical Trials as Topic ; Diabetes Mellitus, Type 2/blood/drug therapy ; Drug Therapy, Combination ; Female ; Glipizide/administration & dosage ; Hemoglobin A, Glycosylated/analysis ; Humans ; Insulin/administration & dosage/secretion ; Male ; Middle Aged ; Sulfonylurea Compounds/administration & dosage|
|[en] The present study aimed at 1) investigating the effect of a combined insulin + glipizide treatment on the metabolic control (HbA1c levels) and insulin requirements (Biostator assessment) in ten non-obese Type-II diabetic patients with recent secondary failure to sulfonylureas; and 2) characterizing the relative contributions of changes in endogenous insulin secretion (C-peptide response) and insulin sensitivity (insulin-induced glucose disposal in clamped conditions) to this effect. The patients were treated in a randomized cross-over order with either insulin alone or insulin + glipizide (3 X 10 mg/day) during two periods averaging 6 weeks each. Mean HbA1c levels were similar in both experimental conditions (8.2 +/- 0.6 vs 7.9 +/- 0.6%, NS). In fact, during the combined therapy, HbA1c levels decreased in five subjects (from 8.6 +/- 0.7 to 7.1 +/- 0.5%; 'responder'), but not in the five others ('non-responders'); the 20-h Biostator insulin infusion was significantly decreased in the responders (29%; P less than 0.05), but not in the non-responders. Basal (0.271 +/- 0.086 vs 0.086 +/- 0.017 nmol/l; P less than 0.05) and post-glucagon (0.468 +/- 0.121 vs 0.180 +/- 0.060 nmol/l; P less than 0.05) C-peptide plasma levels were significantly higher in the responders than in the non-responders; in addition, glipizide significantly increased basal C-peptide concentrations in the responders only (+68%; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)|
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