- Short-term Therapeutic Efficacy of Different Oral Hypoglycemic Agents Combined with Once Daily Insulin Glargine in Type 2 Diabetic Subjects with Failure of Sulfonylurea and Metformin Combination.
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Seong Il Hong, Hyeong Jin Kim, Jong Myon Bae, Sun Ok Song, Kyung Suk Park, Byung Soo Jeon, Seun Duk Hwang, Jin Yi Choi, Jeong Hun Kim, Hyuk Jin Kwon, Ja Sung Choi, Myoung Lyeol Woo, Ji Hoon Cho, Young Jun Won
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Korean Diabetes J. 2007;31(4):336-342. Published online July 1, 2007
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DOI: https://doi.org/10.4093/jkda.2007.31.4.336
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 Abstract
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- Backgroud: Although the extended duration of action of insulin glargine supports a convenient once daily injection, the combination with other short acting insulins or oral hypoglycemic agents is required to control postprandial hyperglycemia in type 2 diabetes. The present study was designed to compare the short-term therapeutic efficacy of oral hypoglycemic agents with once daily insulin glargine, switching from a multiple daily injection regimen. METHODS: After control with the intensive regimen (daily lispro insulin and glargine) during 5~7 days, 80 in-patients with type 2 diabetes were randomized and treated with four oral hypoglycemic agents (glimepiride 4 mg qd, metformin 500 mg bid, nateglinide 90 mg tid, or acarbose 100 mg tid) plus once daily insulin glargine during 5 days. Blood glucose concentration was recorded by seven daily estimations (before each meal, 2 hours after each meal, and bedtime). Blood glucose concentrations and area under the curves (AUCs) of blood glucose were compared among four groups. RESULTS: The area under the curve of blood glucose of metformin, glimepiride, nateglinide, and acarbose groups were 165.5 +/- 46.0, 178.5 +/- 36.5, 209.9 +/- 55.1, and 224.9 +/- 55.8 mmol/L/hr respectively. Blood glucose concentrations and area under the curves of blood glucose of glimepiride and metformin groups were significantly lower than those of acarbose group. Also, those of metformin group were significantly lower than those of nateglinide group. Conclusions: Metformin or glimepiride are more effective oral hypoglycemic agent than nateglinide or acarbose in the combination with insulin glargine in type 2 diabetic subjects with failure of sulfonylurea and metformin combination.
- Insulin Enhances Suppressive Effect of Lipopolysaccharide on Glucose-induced Proliferation of Vascular Smooth Muscle Cells.
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Hyoung Chul Choi, Hyuk Jin Kwon, Kwang Youn Lee
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Korean Diabetes J. 2004;28(4):265-272. Published online August 1, 2004
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Abstract
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- BACKGROUND
Vascular smooth muscle cell (VSMC) proliferation is a major pathologic finding of atherosclerotic vessels in diabetes mellitus. Lipopolysaccharide (LPS) inhibits the VSMC proliferation by NO production via iNOS expression. This study attempted to investigate the effect of LPS on the glucose-induced proliferation of VSMC and its mechanism of action. The effects of insulin on glucose induced VSMC proliferation and on the expression of iNOS were also investigated. METHODS: VSMCs were primarily cultured from rat aorta. A proliferation assay for VSMC was performed by a cell count. The concentrations of nitrite in culture media were measured using the Griess reaction. Western blots were performed to analyze for iNOS protein. RESULTS: D-glucose induced VSMC proliferation in a concentration-dependent manner. LPS inhibited the D-glucose induced VSMC proliferation by increasing ing nitrite production. Insulin suppressed the D-glucose induced VSMC proliferation and potentiated the LPS-induced inhibition of VSMC proliferation by increasing the nitrite production. Insulin potentiated the LPS-induced expression of iNOS. CONCLUSION: These results suggest that in diabetes mellitus, glucose induces VSMC proliferation, and LPS and insulin inhibit the stimulatory action of glucose on VSMC proliferation, and insulin potentiates the inhibitory action of LPS on VSMC proliferation via a increase in the expression of iNOS.
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KDA
