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Different effects of insulin and oral antidiabetic agents on glucose and energy metabolism in Type 2 (non-insulin-dependent) diabetes mellitus

Different effects of insulin and oral antidiabetic agents on glucose and energy metabolism in... 125 32 32 8 8 L. Groop E. Widén A. Franssila-Kallunki A. Ekstrand C. Saloranta C. Schalin J. Eriksson Fourth Department of Medicine Helsinki University Hospital Helsinki Finland Summary Which therapy should be used in Type 2 (noninsulin-dependent) diabetic patients with “secondary sulfonylurea failure”, insulin or a combination of sulfonylurea and metformin? To address this question, we have compared the effect of 6 months of insulin therapy twice daily with that of a combination of glibenclamide and metformin in 24 Type 2 diabetic subjects, who no longer responded to treatment with sulfonylureas. Both treatments resulted in an equivalent 30% improvement in mean daily blood glucose ( p <0.001), without significant effect on serum lipids. Insulin improved glycaemic control primarily by reducing basal hepatic glucose production ( p <0.05), but had no significant effect on peripheral glucose metabolism. The combination of glibenclamide and metformin enhanced significantly total body glucose metabolism ( p <0.05), predominantly by stimulating the non-oxidative pathway. Neither insulin nor the combination therapy altered B-cell response to a test meal. Insulin therapy resulted in a 6% increase in body weight, 63% of which was accounted for by increased fat mass. Although body weight was unchanged during sulfonylurea/metformin therapy, lean body mass and energy expenditure decreased significantly ( p <0.05). We conclude that insulin and glibenclamide/metformin have different long-term effects on glucose and energy metabolism in Type 2 diabetes. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Diabetologia Springer Journals

Different effects of insulin and oral antidiabetic agents on glucose and energy metabolism in Type 2 (non-insulin-dependent) diabetes mellitus

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References (32)

Publisher
Springer Journals
Copyright
Copyright © 1989 by Springer-Verlag
Subject
Medicine & Public Health; Human Physiology; Internal Medicine; Metabolic Diseases
ISSN
0012-186X
eISSN
1432-0428
DOI
10.1007/BF00285334
Publisher site
See Article on Publisher Site

Abstract

125 32 32 8 8 L. Groop E. Widén A. Franssila-Kallunki A. Ekstrand C. Saloranta C. Schalin J. Eriksson Fourth Department of Medicine Helsinki University Hospital Helsinki Finland Summary Which therapy should be used in Type 2 (noninsulin-dependent) diabetic patients with “secondary sulfonylurea failure”, insulin or a combination of sulfonylurea and metformin? To address this question, we have compared the effect of 6 months of insulin therapy twice daily with that of a combination of glibenclamide and metformin in 24 Type 2 diabetic subjects, who no longer responded to treatment with sulfonylureas. Both treatments resulted in an equivalent 30% improvement in mean daily blood glucose ( p <0.001), without significant effect on serum lipids. Insulin improved glycaemic control primarily by reducing basal hepatic glucose production ( p <0.05), but had no significant effect on peripheral glucose metabolism. The combination of glibenclamide and metformin enhanced significantly total body glucose metabolism ( p <0.05), predominantly by stimulating the non-oxidative pathway. Neither insulin nor the combination therapy altered B-cell response to a test meal. Insulin therapy resulted in a 6% increase in body weight, 63% of which was accounted for by increased fat mass. Although body weight was unchanged during sulfonylurea/metformin therapy, lean body mass and energy expenditure decreased significantly ( p <0.05). We conclude that insulin and glibenclamide/metformin have different long-term effects on glucose and energy metabolism in Type 2 diabetes.

Journal

Diabetologia – Springer Journals

Published: Aug 1, 1989

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