Abstract
The traditional sulfonylureas with long half-lives have sustained stimulatory effects on insulin secretion compared to the short-acting insulin secretagogue. In this study, we used the frequently sampled intravenous glucose tolerance test (FSIGT) to evaluate the insulin sensitivity (IS), glucose sensitivity (SG), and acute insulin response after glucose load (AIRg) after 4 months treatment with either gliclazide or repaglinide. The design of study was randomizedcrossover. We enrolled 20 patients with new-onset type 2 diabetes (mean age, 49.3 years). Totally three FSIGTs were performed, one before and one after each of the two treatment periods as aforementioned. No significant differences in fasting plasma glucose, insulin, body mass index, blood pressure, glycated hemoglobin, or lipids were noted between the two treatments. After the repaglinide treatment, higher AIRg, lower IS, and lower SG were noted, but they did not reach statistical significance. The disposal index (DI) was also not significantly different between the two treatments. In conclusion, since non-significantly higher DI, AIRg, lower IS and SG were noted after repaglinide treatment, it might be a better treatment for diabetes, relative to gliclazide.
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References
Anonymous. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 20, 1183–1197 (1997).
Davies, M. J., Rayman, G., Grenfell, A., Gray, I. P., Day, J. L., and Hales, C. N., Loss of the first phase insulin response to intravenous glucose in subjects with persistent impaired glucose tolerance. Diabet. Med., 11, 432–436 (1994).
DeFronzo, R. A., Tobin, J. D., and Andres, R., Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am. J. Physiol., 237, E214-E223 (1979).
Fukushima, M., Usami, M., Ikeda, M., Nakai, Y., Taniguchi, A., Matsuura, T., Suzuki, H., Kurose, T., Yamada, Y., and Seino, Y., Insulin secretion and insulin sensitivity at different stages of glucose tolerance: a cross-sectional study of Japanese type 2 diabetes. Metabolism, 53, 831–835 (2004).
Galvin, P., Ward, G., Walters, J., Pestell, R., Koschmann, M., Vaag, A., Martin, I., Best, J. D., and Alford, F., A simple method for quantitation of insulin sensitivity and insulin release from an intravenous glucose tolerance test. Diabet. Med., 9, 921–928 (1992).
Kahn, S. E., The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia, 46, 3–19 (2003).
Kolterman, O. G., Gray, R. S., Shapiro, G., Scarlett, J. A., Griffin, J., and Olefsky, J. M., The acute and chronic effects of sulfonylurea therapy in type II diabetic subjects. Diabetes, 33, 346–354 (1984).
Korytkowski, M., Thomas, A., Reid, L., Tedesco, M. B., Gooding, W. E., and Gerich, J., Glimepiride improves both first and second phases of insulin secretion in type 2 diabetes. Diabetes Care, 25, 1607–1611 (2002).
Korytkowski, M. T., Berga, S. L., and Horwitz, M. J., Comparison of the minimal model and the hyperglycemic clamp for measuring insulin sensitivity and acute insulin response to glucose. Metabolism, 44, 1121–1125 (1995).
Kosaka, K., Kuzuya, T., Yoshinaga, H., and Hagura, R., A prospective study of health check examinees for the development of non-insulin-dependent diabetes mellitus: relationship of the incidence of diabetes with the initial insulinogenic index and degree of obesity. Diabet. Med., 13, S120–S126 (1996).
McFadzean, A. J. and Yeung, R., Diabetes among the Chinese in Hong Kong. Diabetes, 17, 219–228 (1968).
Mehring, G. H., Coates, P. A., Brunel, P. C., Luzio, S. D., and Owens, D. R., Insulin sensitivity in type 2 diabetes: univariate and multivariate techniques to derive estimates of insulin sensitivity from the insulin modified intravenous glucose tolerance test (FSIGT). Comput. Methods Programs Biomed., 68, 161–176 (2002).
Meigs, J. B., Cupples, L. A., and Wilson, P. W., Parental transmission of type 2 diabetes: the Framingham Offspring Study. Diabetes, 49, 2201–2207 (2000).
O’Rahilly, S., Barroso, I., and Wareham, N. J., Genetic factors in type 2 diabetes: the end of the beginning? Science, 307, 370–373 (2005).
Ohmura, T., Ueda, K., Kiyohara, Y., Kato, I., Iwamoto, H., Nakayama, K., Nomiyama, K., Ohmori, S., Yoshitake, T., and Shinkawa, A., The association of the insulin resistance syndrome with impaired glucose tolerance and NIDDM in the Japanese general population: the Hisayama study. Diabetologia, 37, 897–904 (1994).
Qiao, Q., Nakagami, T., Tuomilehto, J., Borch-Johnsen, K., Balkau, B., Iwamoto, Y., and Tajima, N., International Diabetes Epidemiology Group; DECODA Study Group. Comparison of the fasting and the 2-h glucose criteria for diabetes in different Asian cohorts. Diabetologia, 43, 1470–1475 (2000).
Saad, M. F., Anderson, R. L., Laws, A., Watanabe, R. M., Kades, W. W., Chen, Y. D., Sands, R. E., Pei, D., Savage, P. J., and Bergman, R. N., A comparison between the minimal model and the glucose clamp in the assessment of insulin sensitivity across the spectrum of glucose tolerance. Insulin Resistance Atherosclerosis Study. Diabetes, 43, 1114–1121 (1994).
Sekikawa, A., Tominaga, M., Takahashi, K., Eguchi, H., Igarashi, M., Ohnuma, H., Sugiyama, K., Manaka, H., Sasaki, H., and Fukuyama, H., Prevalence of diabetes and impaired glucose tolerance in Funagata area, Japan. Diabetes Care, 16, 570–574 (1993).
Simonson, D. C., Ferrannini, E., Bevilacqua, S., Smith, D., Barrett, E., Carlson, R., and DeFronzo, R. A., Mechanism of improvement in glucose metabolism after chronic glyburide therapy. Diabetes, 33, 838–845 (1984).
Tripathy, D., Carlsson, M., Almgren, P., Isomaa, B., Taskinen, M. R., Tuomi, T., and Groop, L. C., Insulin secretion and insulin sensitivity in relation to glucose tolerance: lessons from the Botnia Study. Diabetes, 49, 975–980 (2000).
Tsu, S. H., Clinical features of diabetes in Taiwan. Diabetes Mellitus in Asia, ed. Baba, S., Goto, T., and Fukui, E., Exerpta Media, Amsterdam (1976).
Tusie Luna, M. T., Genes and type 2 diabetes mellitus. Arch. Med. Res., 36, 210–222 (2005).
Welch, S., Gebhart, S. S., Bergman, R. N., and Phillips, L. S., Minimal model analysis of intravenous glucose tolerance test-derived insulin sensitivity in diabetic subjects. J. Clin. Endocrinol. Metab., 71, 1508–1518 (1990).
Yki-Jarvinen, H., Toxicity of hyperglycaemia in type 2 diabetes. Diabetes Metab. Rev., 14(Suppl 1), S45–S50 (1998).
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Wu, CZ., Pei, D., Hsieh, AT. et al. Comparison of insulin sensitivity, glucose sensitivity, and first phase insulin secretion in patients treated with repaglinide or gliclazide. Arch. Pharm. Res. 33, 411–416 (2010). https://doi.org/10.1007/s12272-010-0310-6
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DOI: https://doi.org/10.1007/s12272-010-0310-6