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Glipizide increases plasma insulin but not C-peptide level after a standardized breakfast in type 2 diabetic patients (1984)

Scheen, A. J. ; Lefebvre, P. J. ; Luyckx, A. S.

Springer

European journal of clinical pharmacology 26 (1984), S. 471-474

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ISSN: 1432-1041

Keywords: glipizide ; diabetes Type 2 ; C-peptide plasma level ; insulin plasma level ; sulphonylurea ; insulin secretion

Source: Springer Online Journal Archives 1860-2000

Topics: Chemistry and Pharmacology , Medicine

Notes: Summary Peripheral blood glucose, plasma insulin and C-peptide levels were investigated after giving a standardized breakfast (500 kcal, 60g carbohydrates) to 10 nonobese Type 2 diabetic patients previously treated by diet alone. Each patient received at random, at 1 week intervals, either 5 mg glipizide (meal + glipizide) or a placebo (meal alone) 30 min before breakfast. Basal values of blood glucose, plasma insulin and C-peptide were similar on both occasions. After meal + glipizide, the blood glucose increase was sharply limited whereas the rise in plasma insulin was steeper and reached twice as high a level. In contrast, the rise in plasma C-peptide was similar in both conditions. Consequently, the areas under the curves (0–300 min) showed a marked reduction in blood glucose after meal + glipizide (2289±149 versus 3101±169 mmol·min/l; 2p〈0.001), associated with a significant increase in plasma insulin (14219±3261 versus 7591±1173 µU·min/ml; 2p〈0.025) but no significant change in plasma C-peptide (342±45 versus 326±34 pmol·min/ml; N.S.). The insulin/C-peptide molar ratio was thus significantly increased after meal + glipizide (0.41±0.06 versus 0.23±0.04 at the 60th min; 2p〈0.02). The dissociation between the responses of insulin and C-peptide suggests that a single dose of 5 mg glipizide in Type 2 diabetic subjects may enhance availability of peripheral insulin by extrapancreatic mechanism(s). This phenomenon may result in a higher circulating level of the hormone and therefore represent a further mode of action of sulphonylureas. Finally, the usual concept that peripheral insulin levels reflect true insulin secretion may be misleading in studies dealing with sulphonylureas.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00542143

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Diuretic activity of torasemide and furosemide in chronic heart failure: A comparative double blind cross-over study (1986)

Scheen, A. J. ; Vancrombreucq, J. C. ; Delarge, J. ; [et al.]

Springer

European journal of clinical pharmacology 31 (1986), S. 35-42

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ISSN: 1432-1041

Keywords: torasemide ; furosemide ; diuretic activity ; chronic heart failure ; electrolyte excretion

Source: Springer Online Journal Archives 1860-2000

Topics: Chemistry and Pharmacology , Medicine

Notes: Summary The diuretic effects of torasemide and of furosemide were compared in a double blind cross-over study in 13 patients with stable chronic heart failure. Single doses of 10 mg and 20 mg of torasemide and of 40 mg of furosemide were given orally, in a randomized order on 3 consecutive days. In addition, a placebo was administered on the day preceding the 3 active drug treatment days to obtain control data. Each experimental day was divided into three urine collection periods — 0 to 4 h, 4 to 12 h and 12 to 24 h. Urine output, ion excretion and clearance were measured during each of the 3 periods as well as for the 24-h period. Torasemide 20 mg was distinctly more active in each of the 3 collection periods and in the 24-h period than furosemide 40 mg, whereas no significant difference was found between furosemide 40 mg and torasemide 10 mg for most of the experimental data. From 0 to 4 h, both torasemide and furosemide significantly increased the urinary flow rate and the urinary excretion of sodium, chloride and calcium, while they decreased the urinary osmolality when compared to placebo. All the effects persisted in the 4 to 12 h period after torasemide 20 mg in contrast to furosemide, whose effects were limited to the 0 to 4 h period. In the third period (12–24 h), the urine volume fell below the placebo value after furosemide but not torasemide, and only torasemide 20 mg was followed by a persistent decrease in the urine osmolality. Both diuretics increased the free water clearance, but this phenomenon was slightly greater after torasemide. Finally, urinary potassium excretion was increased by both doses of torasemide and furosemide, with no significant difference between the three experiments. Torasemide and furosemide were well tolerated; no clinical or biochemical adverse effects occurred after administration of either of the compounds. Torasemide is a new loop diuretic which may constitute a good alternative to furosemide in the treatment of oedema in chronic heart failure.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00541465

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