title: Valproate modulates glucose metabolism in patients with epilepsy after first exposure.
abstract: Valproate (VPA) treatment has been reported to be associated with weight gain and metabolic changes, such as hyperinsulinemia. The question of whether hyperinsulinemia and other metabolic changes are consequences of increased weight, or are instead direct results of VPA treatment, remains a matter of debate. The aim of the current study was to explore the influence of VPA treatment on glucose and insulin levels during the oral glucose tolerance test (OGTT) directly following the first intravenous (IV) administration. Sixteen patients (18-46 years old) with newly diagnosed epilepsy underwent an OGTT with 75 g glucose prior to the start of VPA treatment, as well as directly following the first IV VPA administration. We observed that plasma glucose levels during the 120 min of OGTT session following infusion of VPA were significantly lower than those measured during OGTT without VPA treatment (mean ± standard deviation [SD] 4.28 ± 0.94 mmol/l vs. 4.75 ± 1.09 mmol/l respectively, p = 0.038). However, blood concentrations of insulin and C-peptide did not differ significantly between the two measurements. This is the first study to show a potential acute glucose-lowering effect of VPA during OGTT in patients with newly diagnosed epilepsy.
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.|Neurology Clinic, Tartu University Hospital, Tartu, Estonia.
authors.forename: Aleksei
authors.initials: A
authors.lastname: Rakitin
authors.affiliation: Department of Pathophysiology, University of Tartu, Tartu, Estonia.|Center of Translational Medicine, University of Tartu, Tartu, Estonia.
authors.forename: Sulev
authors.initials: S
authors.lastname: Kõks
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.|Neurology Clinic, Tartu University Hospital, Tartu, Estonia.
authors.forename: Sulev
authors.initials: S
authors.lastname: Haldre
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage*; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism*; D018592:Cross-Over Studies; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D014635:Valproic Acid / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D001786:Blood Glucose; D014635:Valproic Acid; D005947:Glucose
keywords: Glucose; Insulin; Insulin resistance; Valproate; Valproic acid