Is sulphonylurea therapy effective long term? A 3-year study with gliclazide.
Fifty non-insulin-dependent diabetic patients, aged 59.06 +/- 1.37 years and overweight (119.3% of ideal body weight), with an impaired daily glycaemic profile despite a carbohydrate restrictive diet were treated with gliclazide (40 to 320 mg per day) for 36 months. Forty-four patients completed the full study (3 drop-outs for secondary failure, 3 others for reasons not related to the treatment). Mean daily plasma glucose levels (fasting, 10.00, 12.00 and 16.00 hours) decreased significantly from 15.2 +/- 0.7 to 6.9 +/- 0.2 mmol/l after 36 months. Mean fasting plasma glucose level decreased significantly from 12.7 +/- 0.5 to 8.2 +/- 0.2 mmol/l after 3 months and continued to decrease to 6.9 +/- 0.3 mmol/l after 36 months (p less than 0.01). Fatty acids, cholesterol, and triglycerides plasma levels also decreased significantly from 0.53 +/- 0.06 mmol/l, 6.3 +/- 0.2 mmol/l and 1.9 +/- 0.2 mmol/l, respectively to 0.32 +/- 0.01 mmol/l, 5.8 +/- 0.1 mmol/l and 1.6 +/- 0.1 mmol/l, respectively. No weight gain was observed: mean body weight decreased significantly from 68.2 +/- 1.7 to 64.0 +/- 1.4 kg, indicating that gliclazide did not interfere with diet-induced weight loss. Importantly, platelet adhesiveness, abnormal before treatment 77.2 +/- 1.3% (normal less than 70%), improved throughout the study to 57.8 +/- 1.3% after 36 months of gliclazide. Treatment was well tolerated and no hypoglycaemic attacks or other side-effects were reported.
D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D001835:Body Weight / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D005215:Fasting; D005260:Female; D005500:Follow-Up Studies; D005907:Gliclazide / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010973:Platelet Adhesiveness / Q000187:drug effects; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D013997:Time Factors
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D008055:Lipids; D013453:Sulfonylurea Compounds; D005907:Gliclazide