Glipizide: an overview

This is a brief summary of the extensive clinical experience with glipizide in the treatment of noninsulin-dependent diabetes mellitus. The data demonstrate that this agent, one of the newest oral hypoglycemics, is an effective and safe compound with unique properties. Among its other qualities, it has been shown (1) to stimulate insulin action through extrapancreatic effects that affect insulin-receptor binding and enhance tissue responsiveness to insulin; (2) to favorably influence the principal pathophysiologic abnormalities, defective secretory dynamics, and target-cell resistance to insulin observed in noninsulin-dependent diabetes; (3) to improve control of blood glucose, and when used in conjunction with insulin, to achieve glycemic control with reductions in insulin dosage; (4) to lower the level of plasma glucose and to maintain this effect despite a short half-life; (5) to stimulate insulin secretion following its oral administration; (6) to be more effective than tolbutamide in elderly patients with long-standing diabetes; and (7) to be well tolerated with few side effects. The occurrence of hypoglycemia with its use is uncommon and can be avoided by appropriate precautions and correct usage. These factors seem to recommend its use for the management of noninsulin-dependent diabetes mellitus.