Affiliation:
1. Ruth Collins Diabetes Center, Baylor University Medical Center, Dallas, Texas
2. Diabetes and Glandular Disease Clinic, San Antonio, Texas
3. Novartis Pharmaceuticals, East Hanover, New Jersey
Abstract
OBJECTIVE—This study compared the effects of nateglinide, glyburide, and placebo on postmeal glucose excursions and insulin secretion in previously diet-treated patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—This randomized, double-blind, placebo-controlled multicenter study was conducted in 152 patients who received either nateglinide (120 mg before three meals daily, n = 51), glyburide (5 mg q.d. titrated to 10 mg q.d. after 2 weeks, n = 50), or placebo (n = 51) for 8 weeks. Glucose, insulin, and C-peptide profiles during liquid meal challenges were measured at weeks 0 and 8. At weeks −1 and 7, 19-point daytime glucose and insulin profiles, comprising three solid meals, were measured.
RESULTS—During the liquid-meal challenge, nateglinide reduced the incremental glucose area under the curve (AUC) more effectively than glyburide (Δ = −4.94 vs. −2.71 mmol · h/l, P < 0.05), whereas glyburide reduced fasting plasma glucose more effectively than nateglinide (Δ = −2.9 vs. −1.0 mmol/l, respectively, P < 0.001). In contrast, C-peptide induced by glyburide was greater than that induced by nateglinide (Δ = +1.83 vs. +0.95 nmol · h/l, P < 0.01), and only glyburide increased fasting insulin levels. During the solid meal challenges, nateglinide and glyburide elicited similar overall glucose control (Δ 12-h incremental AUC = −13.2 vs. −15.3 mmol · h/l), but the insulin AUC induced by nateglinide was significantly less than that induced by glyburide (Δ 12-h AUC = +866 vs. +1,702 pmol · h/l, P = 0.01).
CONCLUSIONS—This study demonstrated that nateglinide selectively enhanced early insulin release and provided better mealtime glucose control with less total insulin exposure than glyburide.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Reference18 articles.
1. Lebovitz HE: Insulin secretagogues: old and new. Diabetes Rev 7: 139–153, 1999
2. Kelly D: Approaches to preventing prandial hyperglycemia excursions. Curr Opin Endocrinol Diabetes 6:S7–S11, 1999
3. Jeng C-Y, Hollenbeck CB, Wu MS, Chen YD, Reaven GM: How does glibenclamide lower plasma glucose concentrations in patients with type 2 diabetes? Diabet Med 6:303–308, 1989
4. Rosenstock J, Samols E, Muchmore DB, Schneider J, and The Glimepiride Study Group: Glimepiride, a new once–daily sulfonylurea. Diabetes Care 19:1194–1199, 1996
5. The DCCT Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986, 1993
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