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PubMed2002

Effect of combination glipizide GITS/metformin on fibrinolytic and metabolic parameters in poorly controlled type 2 diabetic subjects.

OBJECTIVE: Epidemiological studies have implicated increased plasminogen-activated inhibitor 1 (PAI-1) as a marker or predictor of accelerated coronary atherosclerotic disease in type 2 diabetes. We sought to determine whether metabolic control, independent of its oral mode of implementation, affects PAI-1 in patients with marked hyperglycemia. RESEARCH DESIGN AND METHODS: A total of 91 subjects were screened, subjected to a 4-week drug washout, and randomized to daily treatment with glipizide GITS (maximum 20 mg, n = 46) or metformin (maximum 2,550 mg, n = 45) as monotherapy. After monotherapy, combination therapy was initiated by adding the second agent to the regimen. Plasma glucose (fasting and postprandial), HbA(1c), fructosamine, and PAI-1 were assayed before and after randomization and sequentially thereafter in all subjects; hepatic glucose output (HGO) and abdominal fat distribution were each measured in a subset of subjects. RESULTS: Glycemic control was markedly impaired at baseline (mean HbA(1c) 10.4 +/- 0.2% glipizide GITS; 10.0 +/- 0.2% metformin) but improved comparably with each agent as monotherapy and in combination (P < 0.0001 vs. baseline), as assessed with meal tolerance studies, fructosamine values, and HGO. Body weight and abdominal fat distribution did not change significantly in either group. PAI-1 concentrations were extraordinarily high (5- to 10-fold more than normal) at baseline (202 +/- 12 ng/ml glipizide GITS; 201 +/- 13 ng/ml metformin) but declined comparably, and significantly, after treatment with either agent as monotherapy and decreased further with combination therapy. CONCLUSIONS: When hyperglycemia is profound, increases in PAI-1 are also profound. Control of hyperglycemia with either glipizide GITS, an insulin secretagogue, or metformin as monotherapy comparably ameliorates elevated PAI-1.

Adult↗
PubMed2003

Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials.

OBJECTIVE: The use of diets with low glycemic index (GI) in the management of diabetes is controversial, with contrasting recommendations around the world. We performed a meta-analysis of randomized controlled trials to determine whether low-GI diets, compared with conventional or high-GI diets, improved overall glycemic control in individuals with diabetes, as assessed by reduced HbA(1c) or fructosamine levels. RESEARCH DESIGN AND METHODS: Literature searches identified 14 studies, comprising 356 subjects, that met strict inclusion criteria. All were randomized crossover or parallel experimental design of 12 days' to 12 months' duration (mean 10 weeks) with modification of at least two meals per day. Only 10 studies documented differences in postprandial glycemia on the two types of diet. RESULTS: Low-GI diets reduced HbA(1c) by 0.43% points (CI 0.72-0.13) over and above that produced by high-GI diets. Taking both HbA(1c) and fructosamine data together and adjusting for baseline differences, glycated proteins were reduced 7.4% (8.8-6.0) more on the low-GI diet than on the high-GI diet. This result was stable and changed little if the data were unadjusted for baseline levels or excluded studies of short duration. Systematically taking out each study from the meta-analysis did not change the CIs. CONCLUSIONS: Choosing low-GI foods in place of conventional or high-GI foods has a small but clinically useful effect on medium-term glycemic control in patients with diabetes. The incremental benefit is similar to that offered by pharmacological agents that also target postprandial hyperglycemia.

Diabetes Mellitus, Type 1↗
PubMed1995

Blood flow velocity waveforms of the fetal middle cerebral artery in pregnancies complicated by diabetes mellitus.

Fetal blood flow velocity waveforms of the middle cerebral artery were measured by pulsed Doppler ultrasound in 43 pregnant women with diabetes mellitus (33 class B, 3 class C, 6 class D and 1 class R). The recordings were performed between 24 and 38 weeks of gestation. A total of 122 recordings were analyzed prior to establishing the resistance index (RI = peak systolic velocity minus diastolic velocity/peak systolic velocity). The mean maternal serum glucose was 124.3 mg/dl (range: 72.7 to 281.5 mg/dl), the mean hemoglobin A1c was 6.03% (range: 3.3 to 11.0%) and the mean fructosamine level was 255.97 mumol/L (range: 205 to 397 mumol/L). The resistance index did not differ between the fetuses of the diabetic mothers in our study population. Additionally, no significant correlation was noted between RI values and serum glucose levels (r = 0.03), hemoglobin A1c levels (r = 0.13) or fructosamine levels (r = 0.04) during the period of 26 to 34 gestational weeks. These data indicate that the RI within the fetal cerebral artery is unaffected by the maternal glycemic control when mean serum glucose levels are below 280 mg/dl.

Blood Flow Velocity↗
PubMed1992

[Clinical significance of measuring glycated fibrinogen in plasma in diabetes mellitus].

The clinical significance of measuring glycated fibrinogen (G Fbg) in plasma was studied using a simple, rapid method for determining plasma G Fbg developed by the authors. This method is based on modified fibrin clot formation for purification of plasma Fbg, and G Fbg was estimated by improved colorimetric fructosamine assay. The values of plasma G Fbg were expressed as glycated polylysine equivalents (mumol/l). In this clinical study, 106 examinees who underwent a screening test for diabetes mellitus (DM) because of glycosuria or hyperglycemia were investigated. According to the WHO diagnostic criteria, they were divided into 3 groups: non DM group (n = 35), impaired glucose tolerance (IGT) group (n = 31) and DM (non-treated) group (n = 40). In addition, healthy controls (n = 40) and treated diabetic patients (DM treated) were involved. Plasma G Fbg/Fbg, fasting plasma glucose (FPG), fructosamine and glycated hemoglobin (HbA1c) were also analyzed in subjects of the 5 groups. Non-treated DM patients showed high levels of plasma G Fbg, which were significantly higher than those of any other groups. G Fbg levels in IGT group were significantly higher than those in healthy controls or the non-DM group. Together with a significant positive correlation between G Fbg and FPG, these results indicate that the levels of plasma G Fbg depend on plasma glucose levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Screening methods for diabetes mellitus in aged group].

There are many methods of screening for diabetes mellitus, for example, blood glucose test, urine sugar test, hemoglobin A1c, fructosamine etc. For the purpose of more efficient screening of diabetes mellitus in elderly groups, these data were analyzed to evaluate validity and ability to estimate prognosis. 1) Validity for screening based on diabetic type was analyzed in 27,074 cases. For screening with the standard level of fasting plasma glucose (FPG) > or = 120 mg/dl, sensitivity was 70.5%, specificity, 94.5%, predictive value, 89.0%, hemoglobin A1c > or = 6.5%, 62.7%, 91.2%, 81.5%, respectively, and fructosamine > or = 290 mumol/L, 54.1%, 92.3%, 78.1%, respectively. FPG had the highest validity. Comparison of validity between the > or = 65-yr group and the < or = 55-yr group was mode. There was significant difference in specificity but sensitivity and predictive value were lower in the > or = 65-yr group. 2) Mean blood glucose levels (BG) +/- S.D. by time after meal were studied. Fasting BG was 84.8 +/- 9.8 mg/dl, 0.5-1 hr. BG after meal, 100.8 +/- 24.5 mg/dl, and 4.5 hr or more, 84.1 +/- 12.8 mg/dl. Based on this data, standard levels for screening based on diabetic type using random blood glucose levels for 0.5-1 hr BG after meals were > or = 130 mg/dl, 1.5-2 hr BG > or = 120 mg/dl, and 3.5 hr or more BG and FBG > or = 100 mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Effect of major improvement in glycemic control on results of cardiovascular function tests in patients with insulin-dependent diabetes mellitus.

OBJECTIVE: To evaluate the effect of major improvement in glycemic control on cardiovascular function tests in patients with insulin-dependent diabetes mellitus (IDDM). METHODS: Eight men with chronic, poorly controlled IDDM (serum fructosamine >300 mmol/L and mean fasting blood glucose >200 mg/dL), who were 24 +/- 6 years of age and had a mean duration of diabetes of 8 +/- 1 years, were studied. No patient had microalbuminuria, was taking medication other than insulin, or had evidence of heart disease. Patients underwent baseline continuous ambulatory blood pressure monitoring, echocardiographic studies, and cardiovascular autonomic function tests, which were repeated after 4 weeks of an intensified insulin treatment program (IITP), during which they reached and maintained blood glucose concentrations and serum fructosamine levels in near-normal, nondiabetic ranges. RESULTS: Substantial changes in glycemic control had no significant influence on results of ambulatory blood pressure monitoring, cardiovascular autonomic function tests, and echocardiographic studies. CONCLUSION: Major improvement in glycemic control during a 1-month period in patients with IDDM had no significant influence on cardiovascular function tests. We cannot exclude the possibility that, after a longer duration of an IITP or in patients with clinically evident heart disease or evidence of major complications of diabetes, different responses might be observed.

Journal Article↗
PubMed1999

[Cord blood insulin level in relation to metabolic control of maternal diabetes, duration of pregnancy and neonatal birth weight].

The aim of the study was to examine whether an association between cord blood insulin level (Ic) and maternal glycemic control, duration of pregnancy as well as neonatal birthweight exists. The study was performed in diabetic group consisted of 149 diabetic mothers (91 with GDM and 58 with IDDM) and 149 their babies as well as in the control group consisted of 100 healthy mothers and 100 their babies. Maternal glycemic control was indirectly assessment by using HbA1c and fructosamine levels estimated on the day of delivery. That was found a significant positive correlation between Ic and maternal HbA1c and fructosamine levels as well as between Ic and neonatal birthweight in the diabetic group. That was also found the significant negative correlation between Ic and duration of pregnancy in the diabetic group. We conclude that fetal hyperinsulinemia is a result of poor glycemic control during the last weeks of diabetic pregnancy. Furthermore the significant association exists between cord blood hyperinsulinemia and preterm delivery as well as higher birthweight of newborns born to diabetic mothers.

Adult↗
PubMed1992

[Lipid metabolism in patients with insulin dependent diabetes. III. Effect of metabolic control of diabetes on the concentration of some blood serum lipid constituents in patients with insulin dependent diabetes].

The levels of the following blood serum lipid constituents: total cholesterol, triglycerides, phospholipids, HDL-cholesterol, lipoprotein fractions, as well as apolipoproteins AI, AII and B, have been determined in patients with insulin-dependent diabetes lasting from 3 months to 15 years in relation to the degree of metabolic control characterized by the levels of fructosamine and glycosylated hemoglobin HbA1c. The group of patients having the level of HbA1c exceeding 10% was characterized by significantly higher levels of cholesterol, triglycerides and Apo-B, and lower content of alpha-lipoprotein as compared to the group with HbA1c level beneath 10%. When fructosamine concentration was considered as an index of metabolic control of diabetes, it was found that the levels of cholesterol, phospholipids and apolipoproteins apo-A and apo-AI are highest in the group with the poor metabolic control and differ significantly from the respective values found in patients with mediocre and good metabolic control. Considering biological role of the individual lipids and lipoproteins, it should be stressed that the proper control of glycaemia is important for preventing the development of atherosclerosis in patients with insulin-dependent diabetes.

Adolescent↗
PubMed1991

[State of lipid metabolism in children and adolescents with insulin-dependent diabetes. I. Evaluation of lipoprotein (A) behavior in children and adolescents with insulin-dependent diabetes].

The level of lipoprotein Lp(a), one of the risk factors of atherosclerosis, was determined in 91 children and adolescents of age ranging from 3.3 to 22 years suffering from insulin-dependent diabetes. The changes in Lp(a) were analyzed in relation to the group of patients, the duration of diabetes, possible genetic factors, other factors predisposing to early onset of atherosclerosis, and occurrence of obesity in the analyzed group. The relation between the level of Lp(a) and other parameters of lipid metabolism (total cholesterol, triglycerides, phospholipids, HDL-cholesterol and apolipoprotein B) as well as a degree of metabolic normalization of diabetes (as assessed by the determination of glycosylated hemoglobin and fructosamine) was studied in addition. No relation between Lp(a) and the factors mentioned above, with exception of glycosylated hemoglobin and fructosamine concentrations, could be demonstrated. The elevated level of Lp(a) in children and adolescents during the period of poor metabolic control of diabetes may constitute an additional risk factor for early onset of atherogenic changes.

Adolescent↗
PubMed1992

Association between insulin and blood pressure in a community population with normal glucose tolerance.

The purpose of this study was to examine the relationship between insulin and BP in patients with normal glucose tolerance. The associations between systolic and diastolic BP, age, body mass index, waist/hip ratio, fasting glucose, insulin, fructosamine, glycosylated haemoglobin, lipid profile, and glucose and insulin two hours after 75 g oral glucose were examined in 1,520 employees of a public utility company and non-medical staff of a district hospital. Patients with impaired glucose tolerance or diabetes mellitus (using WHO criteria) were excluded. In men (mean age 35.6 +/- 8.7 years, n = 769), both systolic and diastolic BP were positively associated with age, body mass index, waist/hip ratio, fasting and 2h glucose and insulin, triglycerides and apolipoprotein B, and were negatively associated with glucose/insulin ration, and high density lipoprotein and cholesterol and its subfractions. However, in multivariate analysis only body mass index, age, fasting glucose and insulin were independent predictors of systolic BP, while only body mass index and age predicted diastolic BP. In women, age, glycosylated haemoglobin, 2h glucose/insulin ratio, 2h glucose, fructosamine and triglycerides were predictors of systolic BP. Fasting or 2h insulin, and glucose/insulin ratios did not predict diastolic BP. The results are compatible with the hypothesis that systolic hypertension may reflect a hyper-insulinaemic state even in those with normal glucose tolerance, independent of age and obesity. The association between plasma lipids and blood pressure is probably mediated by insulin and obesity.

Adult↗
PubMed1992

[Nocturnal use of pirenzepine by a group of insulin dependent juvenile diabetics].

Different studies have shown an elevation of GH levels in insulin-dependent diabetic adults and its modification after pirenzepine administration. We have studied nocturnal GH secretion (NIGHS) and fructosamine levels before and after one month of administering a nocturnal dose of pirenzepine [Gastrozepin (R.) 0.6 mg/kg] in a group of eight young insulin-dependent diabetics, 6 males and 2 females. The ages of the subjects ranged between 12 and 17 years with a mean age of 15.28 years. The most important findings were: 1) The NIGHS was not modified by pirenzepine administration, 10.88 +/- 3.81 ng/ml/min vs 11.25 +/- 7.90 ng/ml/min, p greater than 0.05. However, two patients showed a clear decrease in their G.H. levels. 2) Plasma fructosamine levels were also unaffected, 409 +/- 101 mmol/l vs 361 +/- 127 mmol/l, p greater than 0.05. However, the levels of five individual patients decreased after pirenzepine administration. We conclude that oral pirenzepine administration at this dose does not modify GH secretion nor improve short term metabolic control of the disease in young insulin-dependent diabetics. Further investigation, using higher doses and for a more prolonged period of time, is necessary to know the long term effects of this treatment.

Administration, Oral↗
PubMedDate not supplied

Changes in glycosylated proteins in type-2 diabetic patients with and without complications.

BACKGROUND: Diabetes mellitus constitutes one of the most important problems in developing and developed countries. Increased glycosylation of various proteins in diabetic patients has been reported by many authors. The present study describes the changes in protein glycosylation in diabetic patients with and without diabetic complication. METHODS: The study included one hundred and three subjects. Among them 21 were type 2 diabetic patients without any clinical evidence of chronic diabetic complications, 21 were type 2 diabetic patients with cardiovascular complications, 20 were type 2 diabetic patients with cataract, 20 were type 2 diabetic patients with retinopathy and 21 apparently normal, age, sex and weight matched controls. The patients were selected from Ziauddin Medical University Hospital, Karachi and Jinnah Postgraduate Medical Centre, Karachi. RESULTS: Fasting plasma glucose was increased in all diabetic patients and correlated significantly with glycosylated hemoglobin, glycosylated plasma proteins and serum fructosamine concentrations. There was no significant difference in the levels of fasting plasma glucose, glycosylated plasma proteins, glycosylated hemoglobin, serum fructosamine, hexosamine or sialic acid between diabetic patients with or without chronic complications. Alpha-1 and alpha-2 globulin fraction were significantly increased in diabetic patients without complications, diabetic patients with cardiovascular complications and diabetic patients with cataract. Albumin was found to be decreased in diabetic patients with cataract while gamma globulin was increased in diabetic patients with cardiovascular complications and diabetic patients with cataract. CONCLUSIONS: In uncomplicated diabetic patients alpha-1 and alpha-2 glycoproteins were increased. In diabetic patients with cardiovascular complications alpha-1, alpha-2 and gamma globulin were increased while in diabetic patients with cataract alpha-1, alpha-2 and gamma globulin were increased but serum albumin was significantly decreased.

Blood Proteins↗
PubMed2006

Pregnancy outcomes in pre-gestational and gestational diabetic women in comparison to non-diabetic women--A prospective study in Asian Indian mothers (CURES-35).

BACKGROUND AND OBJECTIVE: Diabetes can complicate pregnancy but it is not the major complication of pregnancy. Though prevalence of diabetes is alarmingly high among Indians there have been very few studies assessing the effect of diabetes on pregnancy outcomes, particularly comparing pre-gestational diabetes mellitus [PGDM] and gestational diabetes [GDM] with non-diabetic mothers. METHODS: Pregnant women attending the Dr. Mohan's Diabetes Specialities Centre, a tertiary care centre for diabetes in Chennai in southern India were selected for the study. PGDM and GDM were defined using standard criteria. Out of the 245 pregnant women with diabetes registered at the centre, follow up data was available for 225, which included 79 PGDM and 146 GDM subjects. Non-diabetic controls (n=30) were recruited from the ongoing population based study the Chennai Urban Rural Epidemiology Study (CURES). Details of outcome variables including abortions, mode of delivery, congenital anomalies and neonate's birth weight were documented. RESULTS: Women with PGDM had significantly higher fasting plasma glucose [p<0.001] and fructosamine [p<0.001] levels compared to GDM. Proportion of women who underwent abortions was 0% in non-diabetic controls, 10.1% in PGDM and 2.7% in GDM and the difference between PGDM and GDM was statistically significant [p = 0.04]. Prevalence of 'low birth weight' babies in the study groups were, 14.3% in non-diabetic mothers, 12.3% in PGDM and 8.2% in GDM. The prevalence of 'large babies' was higher in GDM [27.6%] and PGDM [19.2%] groups compared to non-diabetic controls [7.1%] but the differences reached statistical significance only in the GDM group [p = 0.04]. Prevalence of congenital anomalies was 0% among non-diabetic controls, 3.8% in PGDM and 1.4% in GDM but the differences did not reach statistical significance. A significant increase in frequency of abortions [trend chi square = 5.67, p = 0.017] and 'low birth weight' babies [trend chi square = 4.761,p = 0.029] was observed with increasing fructosamine levels in the diabetic mothers. CONCLUSION: Women with diabetes have worse pregnancy outcomes compared to non-diabetic mothers with and those with pre-gestational diabetes fare worse than those with gestational diabetes. The study emphasizes the fact that strict glycemic control is extremely important during pregnancy.

Adult↗
PubMed1989

[Activity of the coagulation and fibrinolysis in non-insulin-dependent diabetes mellitus. In vivo study].

In vivo study of blood coagulation and fibrinolysis activities in non insulin dependent diabetes mellitus. The aim of the study was to investigate in vivo blood coagulation and fibrinolysis activities in a group of diabetic patients NIDDM with and without vascular complications. For this purpose we determined two sensitive indicators in vivo of blood coagulation and fibrinolytic activities such as fibrinopeptide A and B beta 15-42 respectively. Moreover, we computed the ratio between B beta 15-42 and fibrinopeptide A in order to investigate a possible imbalance in vivo between blood coagulation and fibrinolysis. Control groups were 15 healthy subjects and 28 non diabetic patients affected by atherosclerotic disease. Fibrinopeptide A and B beta values were significantly higher in the diabetic patients than controls but there was no difference between the former group and the atherosclerotic patients. Also, no correlation was found for FPA, B beta, B beta/FPAr and HbAlc, fructosamine and blood glucose levels. There was no difference in B beta, FPA and B beta/FPAr values for patients treated with insulin and for those treated with either hypoglycemic agents or diet. Our data indicate that in diabetic patients fibrinolysis activity is increased, but it cannot counterbalance thrombin activity which appears much more enhanced. Finally, the lack of correlation for FPA, B beta, B beta/FPAr and HbAlc, fructosamine and blood glucose suggests that blood coagulation and fibronolysis abnormalities are not related to the degree of blood glucose control.

Adult↗
PubMed1987

Multiple insulin injections using a pen injector versus insulin pump treatment in young diabetic patients.

Continuous subcutaneous insulin infusion (CSII) of 6 months duration was compared with 6 months of multiple insulin injections (MII) using a pen injector (NovoPen) in a prospective cross-over study with 20 young insulin dependent diabetics by evaluating metabolic control, insulin requirements and patient acceptability. Following both intensified regimens (CSII/MII) serum fructosamine declined significantly from 4.1 +/- 0.7 to 3.4 +/- 0.5 mmol/l and 3.6 +/- 0.7 mmol/l respectively (normal range: 2.2 +/- 0.2 mmol/l). When comparing CSII and MII no significant differences could be demonstrated in mean blood glucose (MBG), fasting plasma ketone bodies, fasting plasma free fatty acids (FFA), fasting plasma human growth hormone (HGH), fasting plasma glucagon or serum fructosamine. Mean insulin requirement was 11.4% higher during MII and glucose instability--demonstrated by the M-values and by the frequency of blood glucose values below 4 mmol/l--was significantly (p less than 0.02) higher during the MII treatment. All of the patients reported a better well-being on both treatment regimens and none of them wanted to go back to conventional therapy (CT). In conclusion, on a long-term basis both regimens result in identical metabolic control, but due to physical discomfort during pump treatment, the insulin pen injector was preferred by the majority (80%) of the patients.

Adult↗
PubMed1987

[Determination of serum glycosylated proteins in normoglycemic patients with cancer].

The nitroblue tetrazolium "fructosamine" test was elaborated by Johnson et al. in 1982. It gives an easy evaluation of the degree of non enzymatic glycosylation of serum proteins. This degree, like the percentage of HbA1C, is a biochemical test of the average level of glycemia and so is useful in diabetic patient management. The authors test "fructosamine" with a Kone-Progress automated analyzer on blood collected without anticoagulant or antiglycolytic substances; if iodoacetate is added to the blood sample, they observed a partial inhibition of chemical reaction. The results of the tests carried on two groups of normoglycemic patients with localized and metastatic cancers don't show significant statistical difference with healthy subjects. The nitroblue tetrazolium test can be used to manage diabetics patients suffering from cancers; however for metastatic and cachectic patients, an accelerated turn-over of proteins might decrease the non enzymatic glycosylation degree.

Blood Glucose↗
PubMed1993

Pancreatic reserve and insulin dose in type 2 diabetic patients.

In order to determine whether there is any relationship between pancreatic reserve and the insulin dose required for achieving a good metabolic control in type 2 diabetic patients with secondary failure to oral hypoglycaemic agents, fasting and post-glucagon C-peptide were determined in thirty-nine type 2 diabetic patients with secondary failure to sulphonylureas and hyperglycaemia < 250 mg/dl who attended an outpatient clinic. M-value was calculated in patients performing self-monitoring of blood glucose. Otherwise, pre- and post-prandial glycaemias were measured bi-weekly as outpatients. HbA1c and fructosamine were assessed monthly. A patient was considered well controlled when he or she fulfilled all the requirements of the European NIDDM Policy Group and the insulin dose necessary for these goals was correlated to the pancreatic reserve. There were two drop-outs. Thirty-five out of the thirty-seven patients complied with the objectives in an average time of 3.14 +/- 1.93 months. At the beginning of the study mean HbA1c was 8.01 +/- 1.40% and fructosamine 343.81 +/- 59.05 micromol/l, whereas at the end of the study the values were 6.91 +/- 0.94% and 291.89 +/- 38.59 micromol/l, respectively (both p < 0.001). Body weight increased from 68.95 +/- 12.40 to 69.44 +/- 12.54 kg (n.s.), while hypoglycaemic events decreased from 1.70 +/- 2.37 to 0.88 +/- 1.33 events/week (p < 0.05). To attain all the objectives, 19.03 +/- 5.98 i.u. (0.28 +/- 0.08 i.u./kg) of insulin were required. Basal and post-glucagon C-peptide were 1.97 +/- 1.24 and 3.29 +/- 1.85 ng/ml, respectively, with an increase of 1.32 +/- 0.78 ng/ml. All these values inversely correlated with insulin dose, especially the increase during the test (r = -0.652 with i.u./kg and r = -0.599 with i.u., both p < 0.01). In conclusion, C-peptide test is a good indicator of the insulin dose required for achieving the aims of metabolic control in type 2 diabetic patients.

Aged↗
PubMed1994

Long-term therapy with terazosin may improve glucose and lipid metabolism in hypertensives: a multicenter prospective study.

The effects of long-term monotherapy with terazosin, an alpha-1 blocker, on blood pressure, glucose tolerance, and serum lipid profiles were prospectively investigated in 53 hypertensive patients: 19 with normal glucose tolerance (NGT) and 34 with impaired glucose tolerance (IGT). The plasma glucose, serum lipids, fructosamine, and glycosylated hemoglobin A1c (HbA1c) levels were determined before and during long-term (6 months) therapy with terazosin. A 75-g oral glucose tolerance test was performed before and during long-term terazosin therapy. Significant falls in both systolic and diastolic blood pressure in both patient groups were maintained during the long-term therapy with terazosin. Neither fasting nor postglucose-load venous plasma glucose levels were altered in either group of patients, and diabetes mellitus did not develop in any patient with NGT during the study. There was no significant change in the insulinogenic index (delta IRI/delta BS at 30 minutes after glucose load) in either patient group. In patients with IGT, glucose intolerance was slightly improved with significant reductions in HbA1c and fructosamine during terazosin therapy. Serum total cholesterol (TC) and triglyceride levels were significantly decreased in patients with IGT. In addition, TC and low density lipoprotein (LDL) cholesterol were significantly decreased in patients with hypercholesterolemia (TC > 220 mg/dL). These results suggest that long-term therapy with terazosin may improve glucose and lipid metabolism in hypertensive patients and terazosin seems to be an antihypertensive agent with beneficial effects for hypertensive patients with either dyslipidemia or impaired glucose metabolism.

Adrenergic alpha-Antagonists↗