Indapamide. Effects on apoprotein, lipoprotein, and glucoregulation in ambulatory diabetic patients.
We evaluated the long-term effects of indapamide, a non-thiazide diuretic, on blood pressure, glucoregulation, free insulin and C-peptide levels, and lipoprotein and apoprotein metabolism in 13 hypertensive diabetic patients for 24 weeks. Indapamide significantly reduced both systolic and diastolic blood pressure by 15% and 17%, respectively. Both mean fasting serum glucose and integrated glucose responses after oral glucose load (75 g) were significantly higher during indapamide therapy than at week 0. The mean fasting and stimulated C-peptide responses were significantly increased despite worsening glucose control. At the end of 24 weeks, mean glycosylated hemoglobin level had increased significantly. Indapamide caused a slight but insignificant rise in the total triglyceride, cholesterol, and low-density lipoprotein cholesterol levels, while the high-density lipoprotein cholesterol level decreased. In addition, the apoprotein A-1 concentrations remained unchanged while the apoprotein B-100 level decreased. Apart from hypokalemia (less than 3.5 mEq/L [less than 3.5 mmol/L]) in three patients that required oral potassium supplementation, biochemical changes were of no clinical consequence.
D000328:Adult; D000368:Aged; D001059:Apoproteins / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D003925:Diabetic Angiopathies / Q000188:drug therapy* / Q000378:metabolism; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D007190:Indapamide / Q000627:therapeutic use*; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D001059:Apoproteins; D001786:Blood Glucose; D002096:C-Peptide; D004232:Diuretics; D006442:Glycated Hemoglobin; D007190:Indapamide; D008074:Lipoproteins