Short-term treatment of glucose intolerance in middle-aged subjects by diet, exercise and sulfonylurea

In a screening survey of women and men 47-54 years old for detection of glucose intolerance (GI), with 75 g oral glucose tolerance tests (OGTT), 25 subjects with GI were randomly selected for a therapeutic trial for normalization of the GI. A control group of 18 GI subjects was chosen randomly from the same health survey and given no treatment for 5-10 months; no significant changes in OGTT variables, body mass index, blood pressure or blood lipids were found in this group during follow-up. The treatment group was given advice concerning a low-sucrose, low-fat, high-fiber and energy-restricted (when overweight) diet and also concerning exercise - single-handed (16 subjects) or in an exercise group (9 subjects). The GI improved in the 25 treated subjects after 6 months of this therapy. Thus the total area under the glucose curve and the 1-h and the 2-h glucose values had decreased, the mean 2-h glucose value was restored to normal (less than 7.0 mmol X l-1) and 48% of the treated subjects had a normal 2-h glucose value. Body mass index, systolic blood pressure, serum cholesterol and serum triglycerides were also reduced at the follow-up. The 6-month result was similar in the subgroup of nine GI subjects who followed the dietary advice and exercised in a group for at least one hour per week during at least three months. Physical working capacity was increased, although non-significantly. Glipizide, 1.25 mg daily, was added at breakfast to ten GI-subjects who still had pathological 2-h glucose values after 6 months of dietary and exercise treatment. After a further 6 months of treatment of these 10 subjects, the total glucose area and the 2-h glucose value were reduced, while the mean 2-h glucose value had not required the normal level. Body mass index was unchanged. Another four subjects in this subgroup now showed a normal 2-h glucose value. In conclusion, the 2-h glucose value was restored to normal in totally 64% of all treated GI subjects after short-term treatment with a diet, exercise and, in some cases, added glipizide.