[Metabolic effects of gliclazide in diabetes type II patients. Study with indirect calorimetry]

An attempt is made to determine the effect of treatment with gliclazide on the manner in which obese patients with noninsulin-dependent diabetes dispose of an oral glucose load. Six patients were studied on two occasions - once after one month of an isocaloric diet containing 40% carbohydrate, and two months after gliclazide had been added. Body weight remained constant throughout the three months. However, fasting plasma glucose concentration fell and mean (+/- SEM) incremental insulin response to oral glucose increased significantly (p less than 0.05) with drug therapy (51.1 +/- 14.6 microU/ml vs 17.1 +/- 1.5 microU/ml). Glucose oxidation significantly improved after gliclazide treatment (16.9 +/- 2.4 g/3 h vs 7.5 +/- 2.1 g/3 h, p less than 0.02) in parallel with the fall in plasma glucose and the increase in insulin response. In addition, glucose storage significantly increased after drug therapy (44.1 +/- 10.1 g/3 h vs 28.4 +/- 7.2 g/3 h, p less than 0.001). In contrast, lipid oxidation fell with gliclazide treatment (7.2 +/- 0.7 g/2 h vs 12.0 +/- 1.7 g/3 h, p less than 0.02). This effect may be explained by improvement of the antilipolytic effect of insulin. In conclusion, improvement in glucose oxidation (25%) and in glucose storage (55%), together with reduced lipid oxidation, was observed after two months of gliclazide therapy.