GLIBENCLAMIDE VS GLICLAZIDE IN TYPE-2 DIABETES OF THE ELDERLY

被引：88

作者：

TESSIER, D

DAWSON, K

TETRAULT, JP

BRAVO, G

MENEILLY, GS

机构：

[1] Centre de Recherche En Gérontologie Et Gériatrie, Hôpital D'youville, Université de Sherbrooke, Sherbrooke, Québec

[2] Division of Geriatrics and Endocrinology, Department of Medicine, University of British Columbia, Vancouver, British Columbia

来源：

DIABETIC MEDICINE | 1994年 / 11卷 / 10期

关键词：

TYPE; 2; DIABETES; ELDERLY; GLIBENCLAMIDE; GLICLAZIDE;

D O I：

10.1111/j.1464-5491.1994.tb00256.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The objective of this study was to compare the effect of two sulphonylureas on the frequency of hypoglycaemic events and glycaemic control in elderly patients with Type 2 diabetes. Twenty-two untreated elderly patients were treated with glibenclamide or gliclazide in a randomized double-blind fashion. Prior to treatment, a biochemical profile, an oral glucose tolerance test, and a 2-h hyperglycaemic glucose clamp (glucose 5.4 mmol l(-zs-1) above baseline) were performed. Patients were seen regularly over 6 months to assess glycaemic control and the frequency of hypoglycaemic reactions. Hyperglycaemic clamp studies and oral glucose tolerance tests were repeated at 1 and 6 months. The area under the curve for the oral glucose tolerance test (glibenclamide: 15.5 +/- 0.7; gliclazide: 14.9 +/- 0.8 mmol l(-1) (p = NS)) and the haemoglobin A1C (glibenclamide: 7.4 +/- 0.2 %; gliclazide: 7.9 +/- 0.5 % (p = NS)) were similar at 6 months. Hypoglycaemic reactions were significantly more frequent with glibenclamide than with gliclazide: 17 vs 4 (p<0.01). Insulin sensitivity index (ml kg(-1) min(-1) pmol(-1) x 100) was increased significantly by glibenclamide but not gliclazide (glibenclamide: 0.284 +/- 0.116 (baseline) vs 0.518 +/- 0.102 (6 months) (p<0.05), gliclazide: 0.260 +/- 0.048 (baseline) vs 0.358 +/- 0.048 (6 months) (p = NS)). We conclude that glycaemic control was equivalent with the two drugs but the incidence of hypoglycaemic reactions was significantly greater with glibenclamide probably because this drug increases insulin sensitivity to a greater degree.

引用

页码：974 / 980

页数：7

共 21 条

[1]

Wilson PWF, Anderson KM, Kannel WB., Epidemiology of diabetes mellitus in the elderly. The Framingham study, Am J Med, 80, pp. 3-8, (1986)

[2]

Asplund K., Wiholm BE, Lithner F., Glibenclamide‐associated hypoglycemia: a report on 57 cases, Diabetologia, 24, pp. 412-417, (1983)

[3]

Baba S., Nakagawa S., Takebe K., Goto Y., Maezewa H., Takeda R., Et al., Comparison of gliclazide and glibenclamide treatment in non‐insulin‐dependent diabetes, Tohoku J Exp Med, 141, pp. 693-706, (1983)

[4]

Andres R., Swerdloff R., Pozefsky T., Coleman D., Manual feedback technique for control of glucose concentration, Automation in Analytic Chemistry, pp. 486-501, (1966)

[5]

McGuire EAH, Helderman JH, Tobin JD, Andrews JD, Berman M., Arterial versus venous sampling on analysis of glucose kinetics in man, J Appl Physiol, 41, pp. 565-573, (1976)

[6]

Walter RM., Hypoglycemia: still a risk in the elderly, Geriatrics, 45, pp. 69-75, (1990)

[7]

Johnson AB, Argyraki M., Thow JC, Jones IR, Bropughton D., Miller M., Et al., The effect of sulphonylurea therapy on skeletal muscle glycogen synthase activity and insulin secretion in newly presenting type 2 (non‐insulin‐dependent) diabetic patients, Diabetic Medicine, 8, (1991)

[8]

DeFronzo RA, Tobin JD, Andres R., Glucose clamp technique: a method for quantifying insulin secretion and resistance, Am J Physiol, 237, (1979)

[9]

Mitrakou A., Vuorinen-Markkola H., Raptis G., Toft I., Mokan M., Strumph P., Et al., Simultaneous assessment of insulin secretion and insulin sensitivity using hyperglycemic clamp, J Clin Endocrin Metab, 75, pp. 379-382, (1992)

[10]

Groop L., Wahlin-Boll E., Groop PH, Totterman KJ, Melander A., Tolppanen EM, Et al., Pharmacokinetics and metabolic effects of glibenclamide and glipizide in type 2 diabetics, Eur J Clin Pharm, 28, pp. 697-704, (1985)

← 1 2 3 →