EFFECT OF GLIPIZIDE TREATMENT ON POSTPRANDIAL LIPEMIA IN PATIENTS WITH NIDDM

The primary goal of the present study was to examine the effects of im proved glycaemic control associated with glipizide treatment on postpr andial lipaemia in non-insulin-dependent diabetic patients. The metabo lism of triglyceride-rich lipoproteins of intestinal origin was assess ed by measuring the retinyl palmitate content in plasma and the Svedbe rg flotation index (Sf) > 400 and Sf 20-400 lipoprotein fractions. Fas ting plasma glucose concentrations (14.5 +/- 0.5 vs 9.0 +/- 0.5 mmol/l ), glycated haemoglobin levels (13.1 +/- 0.6 vs 9.7 +/- 0.6 %), and da ylong plasma glucose concentrations were all significantly lower after glipizide treatment (p < 0.001). The improvement in glycaemic control was associated with increases in insulin-mediated glucose uptake (p < 0.001) and plasma post-heparin lipoprotein and hepatic lipolytic acti vities (p<0.02). Both fasting plasma triglyceride (3.09 +/- 0.51 vs 2. 37 +/- 0.34 mmol/l), and postprandial triglyceride concentrations (p < 0.05-0.001) were lower following glipizide treatment, associated with a significant fall in retinyl palmitate content in all three lipoprot ein fractions (p < 0.02-0.001), with the most substantial decrease see n in the Sf 20-400 fraction. These data indicate that glipizide-induce d improvement in glycaemic control was associated with changes in the metabolism of triglyceride-rich lipoproteins of intestinal origin that would be anticipated to reduce risk of coronary heart disease in non- insulin-dependent diabetic patients.