Long-Term Randomized Placebo-Controlled Double-Blind Therapeutic Comparison of Glipizide and Glyburide: Glycemic control and insulin secretion during 15 months

  1. Stein Vaaler, MD
  1. Hormone Laboratory and the Department of Medicine, Aker Diabetes Research Center, Aker Hospital Oslo, Norway Ullensaker Medical Center, Jessheim Norway Departments of Clinical Pharmacology and Community Health Sciences, University of Lund Malmo, Sweden Medstat Research Lillestrom, Norway
  1. Address correspondence and reprint requests to Kåre I. Birkeland, MD, Hormone Laboratory, Aker Hospital, 0514 Oslo, Norway.

Abstract

OBJECTIVE To examine the long-term (15 months) effects on glycemic control and insulin secretion of glipizide and glyburide treatment in patients with noninsulin- dependent diabetes mellitus (N1DDM).

RESEARCH DESIGN AND METHODS Prospective, randomized, doubleblind, placebo-controlled study on 46 NIDDM patients comparing fasting levels and test-meal responses of glucose and insulin during 15 months of follow-up.

RESULTS A comparable reduction in HbA1c levels by both agents versus placebo was observed throughout the study period, but after a marked initial reduction in both sulfonylurea groups, all three groups showed gradually increasing HbA1c levels. However, both glipizide and glyburide achieved and maintained lowered postprandial glucose levels and increased fasting and postprandial insulin levels compared with placebo.

CONCLUSIONS Both glipizide and glyburide may achieve and maintain glycemic reduction and stimulation of insulin secretion during long-term treatment. However, these agents do not prevent the gradual increase in overall glycemia that develops over time in NIDDM patients.

  • Received January 25, 1993.
  • Revision received July 22, 1993.
  • Accepted July 22, 1993.
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