The Sulfonylurea Glyburide Induces Impairment of Glucagon and Growth Hormone Responses During Mild Insulin-Induced Hypoglycemia
| Autor: | Alexander M.M.F. Appelman, D. Willem Erkelens, Ingeborg van der Tweel, Edith ter Braak, Timon W. van Haeften |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Hypoglycemia Placebo Glucagon Body Mass Index Placebos Glibenclamide Reference Values Internal medicine Glyburide Internal Medicine Humans Hypoglycemic Agents Insulin Medicine Hydrocortisone Advanced and Specialized Nursing Human Growth Hormone business.industry Area under the curve medicine.disease Endocrinology Epinephrine Glucose Clamp Technique Female business medicine.drug |
| Zdroj: | Diabetes Care. 25:107-112 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/diacare.25.1.107 |
| Popis: | OBJECTIVE—The sulfonylurea (SU) glyburide may cause severe and prolonged episodes of hypoglycemia. We aimed at investigating the impact of glyburide on glucose counterregulatory hormones during stepwise hypoglycemic clamp studies. RESEARCH DESIGN AND METHODS—We performed stepwise hypoglycemic clamp studies in 16 healthy volunteers (7 women and 9 men aged 44 ± 10 years). We investigated counterregulatory hormonal and symptom responses at arterialized venous plasma glucose levels (PG) of 3.8, 3.2, and 2.6 mmol/l, comparing 10 mg glyburide orally and placebo in a double-blind, randomized crossover fashion. RESULTS—The increase in plasma glucagon with time from PG = 3.8 onward was smaller for glyburide than for placebo (P = 0.014). Plasma glucagon area under the curve (AUC)60–180 was lower after glyburide than after placebo (1,774 ± 715 vs. 2,161 ± 856 pmol · l–1 · min, P = 0.014). From PG = 3.8 onward, plasma growth hormone (GH) levels with placebo were nearly two times (1.9 [95% CI 1.2–2.9]) as high as with glyburide (P = 0.011). AUC60–180 for GH was lower after glyburide than after placebo (geometric mean [range] 665 [356–1,275] and 1,058 [392–1,818] mU · l–1 · min, respectively; P = 0.04). No significant differences were observed for plasma cortisol, epinephrine and norepinephrine, or incremental symptom scores. CONCLUSIONS—The SU glyburide induces multiple defects in glucose counterregulatory hormonal responses, notably decreases in both glucagon and GH release. |
| Databáze: | OpenAIRE |
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