A novel mechanism of glipizide sulfonylurea action: decreased metabolic clearance rate of insulin

N. Barzilai, P. H. Groop, L. Groop, R. A. DeFronzo

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

To examine whether sulfonylureas inhibit the metabolic clearance rate (MCR) of insulin, 19 healthy young subjects participated in two experiments. In the first protocol (n=10), a 3-h oral glucose load was performed with and without 2 mg of glipizide given 30 min before glucose ingestion. The total insulin response was 60% greater with than without glipizide (5.9±0.6 vs 3.7±0.5 μU/ml;P<0.001). However, the total C-peptide responses were virtually identical (4.7±0.5 vs 4.8±0.4 nmol/l) in both studies. In the second protocol (n=9), the MCR of insulin was measured during 4-h euglycemic insulin clamps performed with and without glipizide. In the study with glipizide, the subjects ingested 5 mg of glipizide at 120 min. The steady-state plasma insulin concentration during the 4th h, i.e., 1-2 h after glipizide ingestion, was significantly higher than during the 2nd h, i.e., before glipizide ingestion (99±22 vs 78±17 μU/ml;P<0.01). In addition, glucose uptake during the 4th h was greater (8.0±1.6 vs 6.4±1.5 mg/kg·min) and the MCR of insulin was reduced (503±126 vs 621±176 ml/m2·min;P<0.01). We conclude that glipizide augments plasma insulin levels both by enhancing its secretion and by decreasing the MCR of insulin.

Original languageEnglish (US)
Pages (from-to)273-278
Number of pages6
JournalActa Diabetologica
Volume32
Issue number4
DOIs
StatePublished - Dec 1 1995
Externally publishedYes

Keywords

  • C-peptide
  • Glipizide
  • Insulin
  • Insulin metabolic clearance rate (MCR)
  • Sulfonylurea

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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