[Effect of glibenclamide therapy on carbohydrate and lipid metabolism and insulin secretion in patients with glucose tolerance disorders : a 5-year study]

Abstract

In normal weight persons with impaired glucose tolerance (IGT; normal fasting glycaemia and pathological glucose tolerance) and still normal or already decreased insulin secretion the influence of glibenclamide (maninil) on the carbohydrate and lipid metabolism as well as the insulin secretion was studied after one year (n = 18), after 2 years (n =13), after 3 years (n = 10) and after 5 years (n = 6). Glucose tolerance and insulin secretion were characterized by means of a 2 hours' glucose infusion test (0.33 g/kg as bolus and 12 mg/kg/min over 120 min). In no case the diabetes became manifest during the 5-year duration of the observation. An improvement of the glucose tolerance could be observed up to 3 years, whereas after a 5-year glibenclamide therapy no certain influence on the glucose tolerance and insulin secretion could be proved. In general the improvement of the glucose tolerance was not associated with an increased secretion of insulin, so that an extrapancreatic effect of glibenclamide (improvement of the peripheral insulin sensitivity?) seems to be possible. A complete normalization of the glucose tolerance could be observed only in some individual cases. The body-weight remained constant in all groups, whereas the concentration of triglyceride and cholesterol decreased in their tendency. From clinical and practical point of view the findings would support the opinion that normal weight persons with IGT, particularly in already decreased insulin secretion, have an indication for a glibenclamide therapy.