[Glinide(s), sulfonylurea(s)].
Diabetic macroangiopathy has already developed before diagnosis of diabetes mellitus. Postprandial hyperglycemia has been known as a risk factor for diabetic macroangiopathy and may be more powerful than fasting hyperglycemia. To intervene in hyperglycemia, insulin secretagogues, glinides which selectively stimulate early meal-induced insulin secretion and improve postprandial hyperglycemia, and sulfonylureas which enhance total daily insulin secretion and improve fasting hyperglycemia, have been prescribed as major oral antidiabetic agents. Few evidences that amelioration of glycemic control with insulin secretagogues lower the risk of cardiovascular diseases have been reported. But current studies have shown that intervention in postprandial hyperglycemia with drugs including glinides decreased thickness of carotid IMT as a surrogate marker of atherosclerosis. Results from on-going large scale intervention study with glinides may clarify whether amelioration of hyperglycemia lower the risk of atherosclerotic events.
Arakawa
Masayuki
M
Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine.
Hirose
Takahisa
T
D001161:Arteriosclerosis / Q000209:etiology / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003510:Cyclohexanes / Q000627:therapeutic use*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000517:prevention & control*; D018149:Glucose Intolerance / Q000150:complications / Q000188:drug therapy; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007211:Indoles / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D054833:Isoindoles; D000077715:Nateglinide; D010649:Phenylalanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019518:Postprandial Period; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*
D003510:Cyclohexanes; D007004:Hypoglycemic Agents; D007211:Indoles; D007328:Insulin; D054833:Isoindoles; D013453:Sulfonylurea Compounds; D000077715:Nateglinide; D010649:Phenylalanine; C087255:mitiglinide