Effect of repaglinide and gliclazide on postprandial control of endogenous glucose production

  • Singhal P
  • Caumo A
  • Cobelli C
 et al. 
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Abstract

The effect of repaglinide and gliclazide on postmeal suppression of endogenous glucose production (EGP) has been studied using a variable-rate tracer methodology. Groups of age-, sex-, and weight-matched type 2 diabetic subjects randomized to gliclazide or repaglinide were studied after ingesting a standard mixed meal (550 kcal; 67% carbohydrate, 19% fat, 14% protein). Plasma glucose profiles were similar in each group and markedly different from that of a nondiabetic control group. Endogenous glucose production was similar basally (3.01 ± 0.30 vs 3.06 ± 0.19 mg/kg per minute, gliclazide and repaglinide, respectively). After glucose ingestion, EGP declined rapidly in both the groups until 30 minutes and the greatest suppression was reached earlier in the repaglinide group [0.88 mg/kg per minute at 120 minutes vs 0.77 mg/kg per minute at 210 minutes in gliclazide group (P . 02) but not significantly different in the repaglinide group (153 ± 25 mg/kg per min2; P =. 17). Repaglinide has minimal physiological advantage over gliclazide, but both therapies for type 2 diabetes fall far short of correcting the endocrine and metabolic abnormalities. © 2004 Elsevier Inc. All rights reserved.

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Authors

  • Parag Singhal

  • Andrea Caumo

  • Claudio Cobelli

  • Roy Taylor

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