Drugs online research references
Metabolism. 1987 Feb;36(2 Suppl 1):22-7.
Monitoring and controlling the patient with non-insulin-dependent diabetes mellitus.
Jaspan JB.
While the prevention of acute metabolic decompensation is no longer a serious problem in treating patients with non-insulin-dependent diabetes mellitus (NIDDM), target organ complications can have serious consequences, including blindness, renal failure, neuropathy, amputation, coronary artery disease, and stroke. The bulk of current evidence suggests that these complications can be minimized or perhaps even avoided by carefully monitoring and controlling the patient's blood glucose levels. Although criteria and standards of control differ widely in various centers, in general acceptable-to-good control in the NIDDM patient would consist of average fasting blood glucose (FBG) levels of less than 140 mg/dL and peak postprandial glucoses of less than 220 to 250 mg/dL. Treatment aimed at attaining these blood glucose levels should begin with dietary management and exercise prescription. General health measurements such as control of blood pressure and avoidance of smoking are especially important in the diabetic patient. When these approaches prove ineffectual, the addition of an oral hypoglycemic agent, preferably a second-generation sulfonylurea is indicated. Glipizide and glyburide are both excellent drug choices, although glyburide may cause hypoglycemia in older patients due to its longer half-life and especially in those with renal insufficiency because of accumulation of biologically active metabolites. In certain well-selected cases, the addition of insulin to oral sulfonylurea therapy may offer improved results over the use of either therapeutic modality alone. The advent of self blood glucose monitoring and periodic glycohemoglobin assessments, now well established in diabetic management, represents a major step forward in the endeavor to optimize standards of blood glucose control in the diabetic population.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3543618&dopt=Abstract
Diabetologia. 1987 Feb;30(2):120-1.
The effect of sulphonylurea on the in vivo tissue uptake of glucose in normal rats.
Mooradian AD.
To evaluate the effect of sulphonylurea on in vivo tissue uptake of glucose, the arterial injection tissue-sampling technique of Oldendorf was used to measure the glucose uptake of brain; liver; subcutaneous fat; and of three skeletal muscles, the masseter, femoris and soleus. Rats gavaged with glipizide 5 mg/kg daily for 5 days were compared to vehicle-treated rats. The serum glucose levels at the time of the experiment were identical in the two groups (10.36 +/- 0.42 mmol/l vs 10.38 +/- 0.36 mmol/l). Glipizide treatment did not result in an increase in glucose uptake by the various tissues studied. It is concluded that, under physiological conditions in non-fasted rats, sulphonylureas do not significantly alter tissue uptake of glucose.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3569696&dopt=Abstract
Am J Med. 1987 Sep 18;83(3A):16-21.
Evaluation of first-generation sulfonylureas and glipizide in non-insulin-dependent diabetes mellitus.
Beisswenger PJ, Dias N, Beckman F.
The current study examines the impact of glipizide, a second-generation sulfonylurea, on diabetes control in patients in whom adequate control was not achieved while receiving treatment with first-generation agents. The interim results of this multicenter study are presented in which patients in whom euglycemia was not achieved based on fasting and two-hour postprandial plasma glucose criteria with first-generation sulfonylureas were given glipizide therapy for 24 weeks. Twenty-three percent of the patients who had only fair results with first-generation sulfonylureas (fasting plasma glucose level of more than 140 mg/dl, postprandial plasma glucose level of more than 175 mg/dl) had good to excellent results with glipizide therapy alone (fasting plasma glucose level of less than 140 mg/dl or less than 115 mg/dl, respectively). Overall, 15.4 percent of patients with fair to poor control using first-generation agents had good to excellent control using glipizide. At least a 25-mg/dl decrease in fasting plasma glucose and postprandial plasma glucose levels was also seen in 47 and 46 percent of patients given treatment with glipizide who had poor control (fasting plasma glucose level of more than 200 mg/dl, postprandial plasma glucose level of more than 235 mg/dl) with first-generation agents. Glipizide was extremely well tolerated, with no significant side effects. Preliminary data indicate that glipizide may provide a significant advantage in terms of safety and efficacy over first-generation agents.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3631118&dopt=Abstract
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