Counterregulatory responses to hypoglycemia differ between glimepiride and glyburide in non diabetic individuals

Metabolism: Clinical and Experimental
Nino G JoyStephen Neil Davis

Abstract

Reported rates of hypoglycemia in patients with type 2 diabetes mellitus are lower with glimepiride as compared to glyburide. The aim of this study was to determine whether physiologic differences in counterregulatory neuroendocrine and metabolic mechanisms during hypoglycemia provide a basis for the observed clinical differences between glimepiride and glyburide. Non-diabetic volunteers (age 38±2years, BMI 26±1kg/m(2)) were studied in a single-blind fashion during separate 2day randomized protocols consisting of 2h hyperinsulinemic (9pmol/kg/min) euglycemic (4.9±0.1mmol) and hypoglycemic (2.9±0.1mmol/L) clamps. Individuals received biologically equivalent doses of glimepiride (4mg) or glyburide (10mg) 1h prior to each glucose clamp (n=11) as well as a control group of placebo studies. Glucose kinetics were calculated using D-Glucose-6-6d2. Insulin and C-peptide levels were increased (p<0.05) during euglycemia in both sulfonylurea groups as compared to placebo. However, despite equivalent hypoglycemia, insulin and C-peptide levels were higher (p<0.05) only after glyburide. Glucagon responses and endogenous glucose production (EGP) were decreased (p<0.05) during hypoglycemia following glyburide administration as compared to glim...Continue Reading

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Citations

Aug 18, 2016·European Heart Journal. Cardiovascular Pharmacotherapy·R KumarT Walther
Feb 13, 2016·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Georgia R Kulina, Elliot J Rayfield
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Aug 9, 2016·Journal of Drug Targeting·Kevin Ita
Oct 29, 2017·Current Diabetes Reports·Magnus F GrøndahlFilip K Knop
Dec 1, 2017·PLoS Neglected Tropical Diseases·Julia A LoosAndrea C Cumino

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