Diabetes PubMed

Male type 2 diabetic patients undertaking the Ramadan fast can safely maintain glycaemic control with evening administration of gliclazide MR 60 mg during the fast, and reverting to a morning schedule thereafter.

These population-based data do not support the concern about an adverse effect of second-generation sulfonylureas on survival after MI and underscore the importance of population-based studies of surveillance of drug safety.

Sulfonylurea drug use is associated with an increased risk of in-hospital mortality among diabetic patients undergoing coronary angioplasty for acute myocardial infarction.

In the UGDP study, published in the 1970s, a high incidence of cardiovascular mortality was found in patients treated with the sulfonylurea agent tolbutamide. Impaired ischaemic preconditioning is presumed to be the most important mechanism for the excess cardiovascular mortality observed.

In three cases acetohexamide (Dymelor), an oral hypoglycemic agent, was mistakenly given to patients instead of acetazolamide (Diamox), which had been prescribed for their glaucoma.

In patients with reduced renal function, peritoneal dialysis may be one way to administer large amounts of glucose with very little administration of fluid in the treatment of acetohexamide-induced hypoglycemia.

In spite of the potential benefits of reversal of insulin resistance and weight reduction, altering therapy of type II diabetes mellitus from insulin to tolazamide may increase blood pressure, thereby increasing cardiovascular risk.

The data suggests that the addition of tolazamide may not be of therapeutic benefit in newly diagnosed juvenile diabetics, although insulin requirements may be reduced.

The elderly patient with type II diabetes should be treated in much the same fashion as a younger person with the same disease, although emphasis needs to be placed on minimizing side effects, drug interactions, and hypoglycemia. Chlorpropamide should not be used in these patients, unless there is no other choice.

These experiments suggest that the primary effect of glyburide on the beta cell is to increase its responsiveness to glucose.

Glimepiride and metformin are effective individually in achieving a glycemic goal with a less daily insulin dose, weight gain, and hypoglycemic episodes in comparison to insulin monotherapy in subjects with type 2 diabetes mellitus with further marked reduction in these parameters when used concurrently.

Moreover, glimepiride appears to possess a greater insulin-sparing property than other sulfonylureas.

Combination therapy of glipizide CR tablets with acarbose was more effective in reducing intra-day and day-to-day glycemic variability than glipizide controlled-release (CR) tablets monotherapy.

C-reactive protein (CRP) in the glyburide and metformin groups was positively associated with changes in weight, but this was not the case with rosiglitazone.

Unless future studies refute current data regarding the efficacy and safety of glyburide, we believe that, owing to its ease of administration, convenience and low cost, glyburide will become the first line of medical treatment in patients with gestational diabetes mellitus within the next few years.

Continuing glimepiride (sulfonylureas) allows a better glycaemic control with less insulin daily dose compared with discontinuing glimepride.

Glimepiride can rapidly and stably improve glycemic control and lipoprotein metabolism, significantly alleviate insulin resistance and enhance fibrinolytic activity.

Therapy with glimepiride improves the relative insulin secretory deficit found in T2DM, has antihyperglycemic efficacy equal to other secretagogues with reduced potential for hypoglycemia and may have additional actions contributing to glycemic control in T2DM.

Taken together, the results show that gliclazide may be more useful for the prevention of diabetic vascular complications than glibenclamide.

Three months after replacing rosiglitazone by gliclazide (Diamicron), the visual acuity of the patient improves to 20/40 in the right eye and 20/30 in the left eye.