Summary
A double-blind, placebo-controlled investigation has been made into the effects of 8 weeks of glipizide treatment in diabetics previously classified as Type 2 but with subsequent attenuation of insulin secretion and thence maintained on exogenous insulin.
Although all patients were exposed to therapeutic plasma concentrations of glipizide, fasting blood glucose, haemoglobin A1 and plasma lipoproteins (HDL, LDL, total cholesterol and triglycerides) did not show any consistent improvement following this treatment.
It appears unlikely that SU (glipizide) has any primary effect on insulin action or on plasma lipoproteins. Its primary action is to augment insulin release and availability, so, its use should be restricted to Type 2 diabetics who retain insulin secretion.
Similar content being viewed by others
References
Ginsberg H, Kimmerling G, Olefsky JM, Reaven GM (1975) Demonstration of insulin resistance in untreated adult diabetic subjects with fasting hyperglycemia. J Clin Invest 55: 454–461
Reaven GM, Berstein R, Davis B, Olefsky JM (1976) Nonketotic diabetes mellitus: insulin deficiency or insulin resistance. Am J Med 60: 80–88
Loubatieres A (1957) The hypoglycemic sulfonamides; history and development of the problem from 1942 to 1955. Ann NY Acad Sci 71: 4–11
Jackson JE, Bressler R (1981) Clinical pharmacology of sulphonylurea hypoglycaemic agents; part 1. Drugs 22: 211–245
Jackson JE, Bressler R (1981) Clinical pharmacology of sulphonylurea hypoglycaemic agents; part 2. Drugs 22: 295–320
Melander A, Wåhlin-Boll E (1983) Clinical pharmacology of glipizide. Am J Med [Suppl Nov 30] p: 41–45
Fineberg SE, Schneider SH (1980) Glipizide versus tolbutamide, an open trial. Diabetologia 18: 49–54
Almér L-O, Johansson E, Melander A, Wåhlin-Boll E (1982) Influence of sulfonylureas on the secretion, disposal and effect of insulin. Eur J Clin Pharmacol 22: 27–32
Scheen AJ, Lefebvre PJ, Luyckx AS (1984) Glipizide increases plasma insulin but not C-peptide level after a standardized breakfast in Type 2 diabetic patients. Eur J Clin Pharmacol 26: 471–474
Wåhlin-Boll E, Groop L, Karhumaa S, Groop P-H, Tötterman K-J, Melander A (1986) Therapeutic equivalence of once- and thrice-daily glipizide. Eur J Clin Pharmacol 31: 95–99
Lebovitz H, Feinglos MN, Bucholtz HK, Lebovitz FL (1977) Potentiation of insulin actions: A probable mechanism for the anti-diabetic action of sulfonylurea drugs. J Clin Endocrinol 45: 601–604
Beck-Nielsen H, Pedersen O, Lindskov HO (1979) Increased insulin sensitivity and cellular insulin binding in obese diabetics following treatment with glibenclamide. Acta Endocrinol 90: 451–462
Pfeifer MA, Halter JB, Graf R, Porte D Jr (1980) Potentation of insulin secretion to nonglucose stimuli in normal man by tolbutamide. Diabetes 29: 335–340
Howard BV, Savage PJ, Berman LJ, Bernett PH (1978) Lipoprotein composition in diabetes mellitus. Atherosclerosis 30: 153–162
Taskinen M-R, Harno K, Kuusi T, Nikkilä EA (1985) Long-term treatment with glipizide increases HDL (HDL2) in type 2 diabetic patients. Abstract, 4th European Symposium on Metabolism, Padua 1985
Calvert GD, Graham JJ, Manik T, Wise PH (1978) Effects of therapy on plasma-high-density-lipoprotein-cholesterol concentration in diabetes mellitus. Lancet 2: 66–68
Lisch HJ, Sarta S (1981) Lipoprotein patterns in diet, sulfonylurea and insulin-treated diabetics. Diabetologia 20: 118–122
Madsbad S, Krarup T, McNair P (1981) Practical clinical value of the C-peptide response to glucagon stimulation in the choice of treatment in diabetes mellitus. Acta Med Scand 210: 153–155
Wåhlin-Boll E, Melander A (1979) High-performance liquid chromatographic determination of glipizide and some other sulfonylurea drugs in serum. J Chromatogr 164: 541–546
Roeslau P, Bernt E, Gruber W (1974) Enzymatische Bestimmungen des Gesamt-Cholesterins in Serum. J Klin Chem Klin Biochem 12: 226–229
Wahlefeld AW (1974) Triglyceride determination after enzymatic hydrolysis. In: Bergmayer HV (ed) Methods of enzymatic analysis. Verlag Chemie Weinheim, FRG, Academic Press, New York, p 1834
Danielsson B, Ekman R, Fex G, Johansson BG, Kristensson H, Nilsson-Ehle P, Wadstein J (1978) Changes in plasma high density lipoproteins in chronic male alcoholics during and after abuse. Scand J Clin Lab Invest 38: 113–119
Friedewald WT, Levy R, Fredrickson DS (1972) Estimation of the concentration of low density lipoprotein cholesterol without the use of the preparative ultracentrifuge. Clin Chem 18: 499–502
Nilsson-Ehle P, Ekman R (1977) Rapid, simple and specific assays for lipoprotein lipase and hepatic lipase. Artery 3: 194–209
Heding LG (1975) Radioimmunological determination of human C-peptide in serum. Diabetologia 11: 541–548
Coburn HJ, Carrol JJ (1973) Improved mammal and automated determination of serum glucose, with use of hexokinase and glucose-6-phosphate dehydrogenase. Clin Chem 19: 127–130
Wåhlin-Boll E, Almér L-O, Melander A (1982) Bioavailability, pharmacokinetics and effects of glipizide in type 2 diabetics. Clin Pharmacokinet 7: 363–372
Nilsson-Ehle P, Garfinkel AS, Schotz MC (1980) Lipolytic enzymes and plasma lipoprotein metabolism. Ann Rev Biochem 49: 667–693
Osei K, O'Dorisio TM, Falko JM (1984) Concomitant insulin and sulfonylurea therapy in patients with type II diabetes. Am J Med 77: 1002–1009
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sartor, G., Ursing, D., Nilsson-Ehle, P. et al. Lack of primary effect of sulphonylurea (glipizide) on plasma lipoproteins and insulin action in former Type 2 diabetics with attenuated insulin secretion. Eur J Clin Pharmacol 33, 279–282 (1987). https://doi.org/10.1007/BF00637562
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00637562