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Vol 3, No 1 (2002): Practical Diabetology
Original articles (translated)
Published online: 2001-12-06
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Importance of early insulin secretion. Comparison of nateglinide and glyburide in previously diet-treated patients with type 2 diabetes

Priscilla A. Hollander, Sherwyn L. Schwartz, Marjorie R. Gatlin, Stephen J. Haas, Hongjie Zheng, James E. Foley, Beth E. Dunning
Diabetologia Praktyczna 2002;3(1):31-38.

open access

Vol 3, No 1 (2002): Practical Diabetology
Original articles (translated)
Published online: 2001-12-06

Abstract

INTRODUCTION. This study compared the effects of nateglinide, glyburide, and placebo on postmeal glucose excursions and insulin secretion in previously diet-treated patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS. This randomized, double-blind, placebo-controlled multicenter study was conducted in 152 patients who received either nateglinide (120 mg before three meals daily, n = 51), glyburide (5 mg q.d. titrated to 10 mg q.d. after 2 weeks, n = 50), or placebo (n = 51) for 8 weeks. Glucose, insulin, and C-peptide profiles during liquid meal challenges were measured at weeks 0 and 8. At weeks — 1 and 7, 19-point daytime glucose and insulin profiles, comprising three solid meals, were measured.
RESULTS. During the liquid-meal challenge, nateglinide reduced the incremental glucose area under the curve (AUC) more effectively than glyburide (D = –4.94 vs. –2.71 mmol • h/l, p < 0.05), whereas glyburide reduced fasting plasma glucose more effectively than nateglinide (D = –2.9 vs. –1.0 mmol/l, respectively, p < 0.001). In contrast, C-peptide induced by glyburide was greater than that induced by nateglinide (D = +1.83 vs. +0.95 nmol • h/l, p < 0.01), and only glyburide increased fasting insulin levels. During the solid meal challenges, nateglinide and glyburide elicited similar overall glucose control (D 12-h incremental AUC = –13.2 vs. –15.3 mmol • h/l), but the insulin AUCinduced by nateglinide was significantly less than that induced by glyburide (D 12-h AUC = +866 vs. +1,702 pmol • h/l, p = 0.01).
CONCLUSIONS. This study demonstrated that nateglinide selectively enhanced early insulin release and provided better mealtime glucose control with less total insulin exposure than glyburide.

Abstract

INTRODUCTION. This study compared the effects of nateglinide, glyburide, and placebo on postmeal glucose excursions and insulin secretion in previously diet-treated patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS. This randomized, double-blind, placebo-controlled multicenter study was conducted in 152 patients who received either nateglinide (120 mg before three meals daily, n = 51), glyburide (5 mg q.d. titrated to 10 mg q.d. after 2 weeks, n = 50), or placebo (n = 51) for 8 weeks. Glucose, insulin, and C-peptide profiles during liquid meal challenges were measured at weeks 0 and 8. At weeks — 1 and 7, 19-point daytime glucose and insulin profiles, comprising three solid meals, were measured.
RESULTS. During the liquid-meal challenge, nateglinide reduced the incremental glucose area under the curve (AUC) more effectively than glyburide (D = –4.94 vs. –2.71 mmol • h/l, p < 0.05), whereas glyburide reduced fasting plasma glucose more effectively than nateglinide (D = –2.9 vs. –1.0 mmol/l, respectively, p < 0.001). In contrast, C-peptide induced by glyburide was greater than that induced by nateglinide (D = +1.83 vs. +0.95 nmol • h/l, p < 0.01), and only glyburide increased fasting insulin levels. During the solid meal challenges, nateglinide and glyburide elicited similar overall glucose control (D 12-h incremental AUC = –13.2 vs. –15.3 mmol • h/l), but the insulin AUCinduced by nateglinide was significantly less than that induced by glyburide (D 12-h AUC = +866 vs. +1,702 pmol • h/l, p = 0.01).
CONCLUSIONS. This study demonstrated that nateglinide selectively enhanced early insulin release and provided better mealtime glucose control with less total insulin exposure than glyburide.
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Keywords

diabetes type 2; early insulin release; postmeal glucose excursion

About this article
Title

Importance of early insulin secretion. Comparison of nateglinide and glyburide in previously diet-treated patients with type 2 diabetes

Journal

Clinical Diabetology

Issue

Vol 3, No 1 (2002): Practical Diabetology

Pages

31-38

Published online

2001-12-06

Bibliographic record

Diabetologia Praktyczna 2002;3(1):31-38.

Keywords

diabetes type 2
early insulin release
postmeal glucose excursion

Authors

Priscilla A. Hollander
Sherwyn L. Schwartz
Marjorie R. Gatlin
Stephen J. Haas
Hongjie Zheng
James E. Foley
Beth E. Dunning

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