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Comparison of the postprandial glucose and insulin profiles with nateglinide and gliclazide in type 2 diabetic patients

Novartis Pharma AG, Basel, Switzerland, anja.schweizer{at}pharma.novartis.com

Michele Ball

Novartis Pharmaceuticals Corp, East Hanover, NJ, USA

David R Owens

Diabetes Research Unit, Landough Hospital, Penarth, Wales

Floriane Cressier

Novartis Pharma AG, Basel, Switzerland

David O Holmes

Novartis Pharma AG, Basel, Switzerland

Patrick Brunel

Novartis Pharma AG, Basel, Switzerland

Aim

The aim of this study was to compare glucose, insulin and proinsulin profiles during nateglinide and gliclazide treatment over an extended postprandial period.

Materials and methods

This double-blind crossover trial was conducted in 23 type 2 diabetic patients (mean HbA1C 6.6%; range 6.0—7.4%) who received, for one week each, nateglinide 120 mg t.i.d., gliclazide 80 mg b.i.d. and placebo, with a one week wash out period between treatments.

Results

The 2-hour postprandial glucose concentration was markedly lower with nateglinide than with gliclazide (5.83 vs. 7.21 mmol/L; p<0.05), as was the post-meal peak glucose elevation (8.63 vs. 9.72 mmol/L; p=0.085), which was associated with earlier, higher and shorter-lived insulin and proinsulin secretory responses. However, 0—7-hour AUCs during standardised meal test for glucose and insulin between the two drugs did not statistically differ. No symptomatic hypoglycaemic events occurred during the 7-hour test period.

Conclusion

Nateglinide was more effective than gliclazide in controlling postprandial hyperglycaemia and showed a faster effect on insulin and proinsulin secretion.

Key Words: postprandial • glucose • hypoglycaemia • insulin • proinsulin • nateglinide • gliclazide.

The British Journal of Diabetes & Vascular Disease, Vol. 2, No. 3, 228-232 (2002)
DOI: 10.1177/14746514020020031601


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