The comparison of second phase insulin secretion in patients treated with repaglinide or gliclazide

• Published in: Diabetes & metabolic syndrome clinical research & reviews 2007-02, Vol.1 (1), p.37-42
• Main Authors: Yang, Chun-Chun, Lin, Jiunn-Diann, Kuo, Ko-Lin, Wu, Chung-Ze, Li, Jer-Chuan, Hung, Yi-Jen, Wang, Tso-Fu, Lee, Chien-Hsing, Kuo, Shi-Wen, Pei, Dee
• Format: Article
• Language: English
• Subjects: Endocrinology & Metabolism; Gliclazide; Insulin secretion; Low dose graded glucose infusion test; Repaglinide
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2006.11.006

Summary Aims Sulfonylurea with long half-life such as gliclazide has sustained stimulation on insulin secretion compared to repaglinide which has short half-life for only about 1 h. In this hospital cohort, randomized, cross-over study, we used modified low dose graded glucose infusion test (M-LDGGI) to evaluate second phase insulin secretion after 4 months of treatment with either gliclazide or repaglinide. Methods Sixteen fresh type 2 diabetes with age of 49.5 ± 2.6 years old and BMI of 25.3 ± 0.9 kg/m2 were included. After titration and maintain dose stage, all cases were randomized to the repaglinide or gliclazide treatment for 4 months. At the end of each treatment period, an M-LDGGI was done. Results The general linear model repeated measurement was used to evaluate the plasma glucose, insulin and insulin/glucose curve during M-LDGGI. Although the plasma insulin and insulin/glucose ratios were higher at 40 min and 100–120 min, they did not reach statistically significant. The area under curve of the plasma glucose, insulin and insulin/glucose ratio was also used to evaluate the secretory capacity of beta cell. Although the AUC of the ratio of plasma insulin/plasma glucose seems to be more evident than the curves, they are still not significantly different with each other. Conclusions In conclusion, although non-significant, better second phase insulin secretion could be noted with treatment of repaglinide than gliclazide for 4 months. Further study with longer duration and larger study cohort are needed to solve this interesting and important question.