LONG-TERM RANDOMIZED PLACEBO-CONTROLLED DOUBLE-BLIND THERAPEUTIC COMPARISON OF GLIPIZIDE AND GLYBURIDE - GLYCEMIC CONTROL AND INSULIN-SECRETION DURING 15 MONTHS

OBJECTIVE- To examine the long-term (15 months) effects on glycemic co ntrol and insulin secretion of glipizide and glyburide treatment in pa tients with noninsulin-dependent diabetes mellitus (NIDDM). RESEARCH D ESIGN AND METHODS- Prospective, randomized, double-blind, placebo-cont rolled study on 46 NIDDM patients comparing fasting levels and test-me al responses of glucose and insulin during 15 months of follow-up. RES ULTS- A comparable reduction in HbA1c levels by both agents versus pla cebo was observed throughout the study period, but after a marked init ial reduction in both sulfonylurea groups, all three groups showed gra dually increasing HbA(1c), levels. However, both glipizide and glyburi de achieved and maintained lowered postprandial glucose levels and inc reased fasting and postprandial insulin levels compared with placebo. CONCLUSIONS- Both glipizide and glyburide may achieve and maintain gly cemic reduction and stimulation of insulin secretion during long-term treatment. However, these agents do not prevent the gradual increase i n overall glycemia that develops over time in NIDDM patients.