Document Detail


Interaction of sulfonylureas and exercise on glucose homeostasis in type 2 diabetic patients.
MedLine Citation:
PMID:  10526729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether the plasma glucose-lowering effects of sulfonylureas and acute submaximal exercise are additive and, accordingly, to determine whether they may increase the risk of hypoglycemia when combined in fasting patients. RESEARCH DESIGN AND METHODS: Eight postabsorptive type 2 diabetic patients were examined at three occasions: after oral sulfonylurea (7 mg glibenclamide), during 60 min of ergometer cycle exercise at 57 +/- 3% of VO2max, and during exercise after glibenclamide. RESULTS: Heart rate, VO2, and lactate responses to exercise were comparable (P > 0.05) on days with and without glibenclamide. Plasma insulin concentrations were always increased by glibenclamide, and they were lowered identically by exercise with and without glibenclamide. However, throughout exercise, absolute concentrations of insulin were lower on days without glibenclamide compared with days with glibenclamide (34.5 +/- 4.7 vs. 47.4 +/- 5.5 pmol/l; P < 0.05). At the start of exercise, glucose concentrations were similar between experiments (P > 0.05). The rate of decrease in glucose during exercise was higher (P < 0.05) on days with both glibenclamide and exercise, compared with days with glibenclamide alone and days with exercise alone (-0.035 +/- 0.009 vs. -0.016 +/- 0.002 and -0.022 +/- 0.005 mmol.l-1.min-1, respectively). Consequently, the glucose nadir was lower on days with glibenclamide and exercise than on days with glibenclamide or exercise alone (6.7 +/- 1.1 vs. 8.1 +/- 0.9 and 7.6 +/- 1.0 mmol/l, respectively; P < 0.05). During exercise, the rate of appearance of plasma glucose determined by 3-[3H]glucose infusion was lower on days with glibenclamide than on days without glibenclamide (2.3 +/- 0.1 vs. 2.9 +/- 0.1 mg.min-1.kg-1; P < 0.05). In contrast, glucose clearance was identical (P > 0.05). CONCLUSIONS: In postabsorptive type 2 diabetic patients, the hypoglycemic action of glibenclamide and exercise is enhanced when the treatments are combined. The interaction reflects an increased inhibition by glibenclamide-enhanced insulin levels of hepatic glucose production when hepatic glucose production is accelerated by exercise.
Authors:
J J Larsen; F Dela; S Madsbad; J Vibe-Petersen; H Galbo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes care     Volume:  22     ISSN:  0149-5992     ISO Abbreviation:  Diabetes Care     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-16     Completed Date:  1999-11-16     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1647-54     Citation Subset:  IM    
Affiliation:
Department of Medical Physiology, Panum Institute, Copenhagen, Denmark. j.j.larsen@mfi.ku.dk
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose / metabolism*
Diabetes Mellitus, Type 2 / blood*,  drug therapy,  therapy*
Epinephrine / blood
Exercise / physiology*
Exercise Test
Glucagon / blood
Glyburide / therapeutic use
Homeostasis
Human Growth Hormone / blood
Humans
Hydrocortisone / blood
Hypoglycemic Agents / therapeutic use*
Insulin / blood
Middle Aged
Norepinephrine / blood
Oxygen Consumption
Physical Exertion / physiology
Sulfonylurea Compounds / therapeutic use*
Time Factors
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 0/Sulfonylurea Compounds; 10238-21-8/Glyburide; 11061-68-0/Insulin; 12629-01-5/Human Growth Hormone; 50-23-7/Hydrocortisone; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 9007-92-5/Glucagon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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