Acute effects of nicorandil on glucose tolerance in subjects with borderline fasting blood glucose levels

The acute effect of the anti-ischemic potassium channel opener nicorandil o n glucose tolerance and post-challenge insulin levels was investigated in 1 1 subjects (6 males and 5 females, age 59+/-2 years) with borderline fastin g blood glucose in a single blinded randomised study. All participantes wer e submitted to two oral glucose tolerance tests in randomised order, once w ithout any premedication and once 30 minutes after oral administration of 2 0 mg nicorandil. This single dose of nicorandil significantly increased blo od glucose levels at 120 minutes (173+/-16 vs. 150+/-11 mg/dl, p<0.05 by AN OVA) and 180 minutes (106+/-11 vs. 88+/-7 mg/dl, p<0.05 by ANOVA) after ing estion of 75 mg of glucose. Serum insulin levels were not significantly alt ered. In conclusion we suggest that controlled studies in patients with cor onary artery disease should be performed to investigate whether long term t reatment with nicorandil increases progression rates from impaired glucose tolerance to type-II diabetes and / or from normal to impaired glucose tole rance with a possibly negative impact on the course of cardiovascular disea se in comparison to conventional anti-anginal drugs.