Investigation of the Mechanism of Action of Glibenclamide and Insulin Administered in Combination in Type-II Diabetic Patients with Secondary Failure to Oral Treatment

2015 ◽  
pp. 13-24
Author(s):  
J. Klujko ◽  
F. H. Schmidt ◽  
H. F. K�hnle ◽  
J. Reiter
2015 ◽  
pp. 33-43
Author(s):  
O. Schwarz ◽  
C. Rosak ◽  
P. H. Althoff ◽  
K. Sch�ffling ◽  
F. H. Schmidt

1987 ◽  
Vol 116 (3) ◽  
pp. 364-372 ◽  
Author(s):  
Manuel Castillô ◽  
André J. Scheen ◽  
Giuseppe Paolisso ◽  
Pierre J. Lefébvre

Abstract. 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 × 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%; 'responders'), but not in the five others ('non-responders'); the 20-h Biostator insulin infusion was significantly decreased in the responders (29%; P < 0.05), but not in the non-responders. Basal (0.271 ± 0.086 vs 0.086 ± 0.017 nmol/l; P < 0.05) and post-glucagon (0.468 ± 0.121 vs 0.180 ± 0.060 nmol/l; P < 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 < 0.05). The insulininduced glucose disposal was significantly increased by glipizide in the responders (+ 23%; P < 0.05), but not in the non-responders; however, this difference could be due to higher plasma free insulin levels (+ 37%; P < 0.02) during the clamp with glipizide in the responders who showed persistent C-peptide stimulation. Thus, combining glipizide with insulin seems to be useful only in Type-II diabetic patients who still have a significant endogenous insulin secretion capable of being stimulated by this compound.


2005 ◽  
Vol 108 (6) ◽  
pp. 507-513 ◽  
Author(s):  
Qing LU ◽  
Ingemar BJÖRKHEM ◽  
Bengt WRETLIND ◽  
Ulf DICZFALUSY ◽  
Peter HENRIKSSON ◽  
...  

Manifestations of vascular disease, including microvascular changes, constitute the major part of the morbidity and mortality in diabetic patients. Oxidative stress has been suggested to play an important role in the vascular dysfunction of diabetic patients. Furthermore, epidemiological observations indicate a beneficial effect of an increased dietary intake of antioxidants. The present study tested the hypothesis that the antioxidant ascorbic acid influences microcirculatory function in patients with Type II diabetes. Patients with Type II diabetes were treated with 1 g of ascorbic acid three times a day for 2 weeks in a randomized placebo-controlled double-blind cross-over design. Microvascular reactivity was assessed by vital capillaroscopy and PRH (post-occlusive reactive hyperaemia). hs-CRP (high-sensitivity C-reactive protein), IL-6 (interleukin-6), IL-1ra (interleukin-1 receptor antagonist) and ox-LDL (oxidized low-density lipoprotein) were analysed. The results showed no significant change in microvascular reactivity assessed after 2 weeks of ascorbic acid treatment. TtP (time to peak) was 12.0±3.3 s before and 11.2±3.5 s after ascorbic acid (n=17). In comparison, TtP was 11.5±2.9 s before and 10.6±2.8 s after placebo (not significant). IL-1ra, IL-6, hs-CRP and ox-LDL did not change significantly after ascorbic acid, neither as absolute or relative values. In conclusion, in contrast with some studies reported previously, we could not demonstrate an effect of continuous oral treatment with ascorbic acid on microvascular reactivity assessed at the level of individual capillaries. Furthermore, we found no indication of an effect on inflammatory cytokines or ox-LDL.


Diabetes ◽  
1992 ◽  
Vol 41 (9) ◽  
pp. 1160-1164 ◽  
Author(s):  
J. C. Levy ◽  
J. L. Morton ◽  
M. Davenport ◽  
A. Beloff-Chain ◽  
R. C. Turner

Diabetes ◽  
1986 ◽  
Vol 35 (11) ◽  
pp. 1206-1214 ◽  
Author(s):  
T. Baba ◽  
T. Ishizaki ◽  
Y. Ido ◽  
K. Aoyagi ◽  
S. Murabayashi ◽  
...  

2020 ◽  
Vol 11 (3) ◽  
pp. 3412-3417
Author(s):  
Ranjit S. Ambad ◽  
Rakesh Kumar Jha ◽  
Lata Kanyal Butola ◽  
Nandkishor Bankar ◽  
Brij Raj Singh ◽  
...  

Prediabetes is a glucose homeostasis condition characterized by decreased absorption to glucose or reduced fasting glucose. Both of these are reversible stages of intermediate hyperglycaemia providing an increased type II DM risk. Pre-diabetes can therefore be viewed as a significant reversible stage which could lead to type II DM, and early detection of prediabetes may contribute to type II DM prevention. Prediabetes patients are at high risk for potential type II diabetes, and 70 percent of them appear to develop Type II diabetes within 10 years. The present study includes total 200 subjects that include 100 Prediabetic patients, 50 T2DM patients and 50 healthy individual. Blood samples were collected from the subjects were obtained for FBS, PPBS, Uric acid and Creatinine estimation, from OPD and General Medicine Wards. Present study showed low levels of Serum Uric Acid in prediabetic and T2DM patients were decreased as compared to control group, while the level of creatinine in prediabetic and diabetic were elevated as compared to control group, were not statically significant. Serum Uric Acid was high in control group and low in prediabetic and diabetic patients. Serum creatinine was declined in control group and increased in prediabetic and diabetic patients with increasing Fasting blood glucose level.


2017 ◽  
Vol 5 (10) ◽  
pp. 1197-1202
Author(s):  
Mahfouz HM ◽  
◽  
HashemA H ◽  
YasserHamed Mostafa ◽  
◽  
...  

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