Effects of tolazamide and exogenous insulin on pattern of postprandial carbohydrate metabolism in patients with non-insulin-dependent diabetes mellitus. Results of randomized crossover trial.

Abstract

To determine whether therapy with exogenous insulin or sulfonylureas results in a postprandial pattern of carbohydrate metabolism in patients with non-insulin-dependent diabetes mellitus (NIDDM) that resembles that in nondiabetic individuals, we employed a dual-isotope technique combined with forearm catheterization to examine meal disposition in NIDDM patients, before and after 3 mo of therapy with tolazamide and after 3 mo of therapy with exogenous insulin, with a randomized crossover design. Results were compared with those observed in nondiabetic subjects. Although both forms of therapy improved chronic glycemic control (glycosylated hemoglobin concentration went from 9.6 +/- 0.7 to 7.6 +/- 0.5 and 7.1 +/- 0.2%, respectively, P less than .01), exogenous insulin resulted in a lower postprandial glycemic response than tolazamide (P less than .001). Both agents comparably increased (P less than .01) fasting and integrated postprandial insulin concentrations. However, the initial rate of postprandial increase was greater with exogenous insulin (P less than .05). Tolazamide (P less than .05) but not exogenous insulin increased postprandial C-peptide concentrations. However, tolazamide did not improve the deficient early insulin release. Both agents (P less than .05) lowered postabsorptive hepatic glucose release (from 2.8 +/- 0.3 to 2.3 +/- 0.2 mg . kg-1 . min-1), but not to normal rates (1.8 +/- 0.1 mg . kg-1 . min-1).(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: R Firth, P Bell, M Marsh, R A Rizza
• Journal: Diabetes (Diabetes) Vol. 36 Issue 10 Pg. 1130-8 (Oct 1987) ISSN: 0012-1797 [Print] United States
• PMID: 3308584 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Blood Glucose
• C-Peptide
• Dietary Carbohydrates
• Insulin
• Tolazamide
• Glucose

Topics

• Blood Glucose (metabolism)
• C-Peptide (blood)
• Clinical Trials as Topic
• Diabetes Mellitus, Type 2 (drug therapy, metabolism)
• Dietary Carbohydrates (metabolism)
• Female
• Food
• Glucose (metabolism)
• Humans
• Insulin (blood, therapeutic use)
• Kinetics
• Liver (metabolism)
• Male
• Middle Aged
• Random Allocation
• Tolazamide (therapeutic use)