CHRONIC ADMINISTRATION OF LEVOSULPIRIDE AND GLYCEMIC CONTROL IN IDDM PATIENTS WITH GASTROPARESIS

Citation
P. Melga et al., CHRONIC ADMINISTRATION OF LEVOSULPIRIDE AND GLYCEMIC CONTROL IN IDDM PATIENTS WITH GASTROPARESIS, Diabetes care, 20(1), 1997, pp. 55-58
Citations number
18
Categorie Soggetti
Endocrynology & Metabolism
Journal title
ISSN journal
01495992
Volume
20
Issue
1
Year of publication
1997
Pages
55 - 58
Database
ISI
SICI code
0149-5992(1997)20:1<55:CAOLAG>2.0.ZU;2-W
Abstract
OBJECTIVE - We evaluated the effect of chronic administration of levos ulpiride, a prokinetic drug that is a selective antagonist for D-2 dop amine receptors, on the glycemic control of IDDM subjects. RESEARCH DE SIGN AND METHODS - The study was performed on 40 long-standing IDDM su bjects with clinical signs of autonomic neuropathy and delayed gastric emptying. Gastric emptying time and glycemic parameters (diurnal glyc emic profile and HbA(1c)) were checked under double-blind conditions b efore and after the administration of levosulpiride at the dosage of 2 5 mg t.i.d. orally for 6 months, or placebo. RESULTS - No significant differences were noted in the glycemic and HbA(1c) values before and a fter 6 months of placebo administration. In contrast, after 6 months o f levosulpiride, glycemic control had improved (HbA(1c) 6.7 +/- 0.4 an d 5.7 +/- 0.3%, P < 0.01; mean daily glycemia 10.9 +/- 0.8 and 8.8 +/- 0.4 mmol/l, P < 0.05, at the start and at the end of the study), whil e the dosage of injected insulin (0.65 +/- 0.02 IU . kg(-1). day(-1)) and the number of severe hypoglycemic episodes remained unchanged. Aft er 6 months of levosulpiride therapy, the time of gastric emptying was significantly reduced from 321 +/- 14 to 261 +/- 9 min (P < 0.001) an d dyspeptic symptoms had improved. CONCLUSIONS - Our results show the importance of gastric emptying in the maintenance of glycemic control and the usefulness of chronic administration of levosulpiride in diabe tic subjects with gastroparesis.