Aim: To analyze the effect of glibenclamide on carbohydrate metabolic parameters, glucose values after standard breakfast in particular, in patients with type 2 diabetes (T2D).
Subjects and methods: Thirty patients aged 57.6 +/- 9.4 years with a 4.4 +/- 4.0-year history of T2D received glibenclamide in a daily dose of 10.9 +/- 4.4 mg in combination with diet therapy for 3 months. Venous plasma glycemia was determined before and at the end of the fasting test, 60 and 120 minutes after a standard breakfast test. The area under the glycemic curve was calculated using the trapezoidal method during the standard breakfast test. Out of all possible formulas reflecting a blood glucose increase in relative values during the test, there were two most acceptable formulas that were chosen for further calculations: (1) the contribution of postprandial glycemia exceeding fasting glycemia to postprandial glycemia exceeding 6.1 mmol/l (OS(1/2)); (2) that of postprandial glycemia exceeding the glycemia of 6.1 mmol/l to postprandial glycemia in the standard breakfast test (OS2/S).
Results: Follow 3-month therapy, glycated hemoglobin (HBA1c) decreased from 8.7 +/- 1.8 to 7.0 +/- 1.0% (p < 0.0001), fasting plasma glucose reduced from 9.8 +/- 2.7 to 8.3 +/- 1.7 mmol/l (p < 0.01); it decreased from 14.8 +/- 3.9 to 13.2 +/- 3.3 mmol/l (p < 0.01) and from 13.3 +/- 3.6 to 11.1 +/- 3.0 mmol/l (p < 0.02) 1 and 2 hours after the load test, respectively. There was a significant reduction in the total area under the glycemic curve (S)--from 1583.5 +/- 405.8 to 1375.7 +/- 320.1 mmol/l x rmin. However, there were no significant changes. There was a significant increase in the relative value OS(1/2) from 51.7 +/- 17.7 to 62.8 +/- 20.0% and a significant reduction in OS2/S. Analysis of the area in relative values (OS(1/2) and OS2/S) obviates the ambiguousness of the results obtained when analyzing the area in absolute values.
Conclusion: Glibenclamide treatment causes a statistically significant reduction in fasting and postprandial plasma glucose levels, glycated hemoglobin, and relative area values during the standard breakfast test.