[Correlation of HBA(1c) and postprandial glycemia during a standard breakfast test in patients with type 2 diabetes mellitus receiving glibenclamide].

ABSTRACT

AIM: To analyze the effect of glibenclamide on carbohydrate metabolic parameters, glucose values after standard breakfast in particular, in patients with type 2 diabetes (T2D). SUBJECTS AND METHODS: Thirty patients aged 57.6 +/- 9.4 years with a 4.4 +/- 4.0-year history of T2D received glibenclamide in a daily dose of 10.9 +/- 4.4 mg in combination with diet therapy for 3 months. Venous plasma glycemia was determined before and at the end of the fasting test, 60 and 120 minutes after a standard breakfast test. The area under the glycemic curve was calculated using the trapezoidal method during the standard breakfast test. Out of all possible formulas reflecting a blood glucose increase in relative values during the test, there were two most acceptable formulas that were chosen for further calculations (1) the contribution of postprandial glycemia exceeding fasting glycemia to postprandial glycemia exceeding 6.1 mmol/l (OS(1/2)); (2) that of postprandial glycemia exceeding the glycemia of 6.1 mmol/l to postprandial glycemia in the standard breakfast test (OS2/S). RESULTS: Follow 3-month therapy, glycated hemoglobin (HBA1c) decreased from 8.7 +/- 1.8 to 7.0 +/- 1.0% (p < 0.0001), fasting plasma glucose reduced from 9.8 +/- 2.7 to 8.3 +/- 1.7 mmol/l (p < 0.01); it decreased from 14.8 +/- 3.9 to 13.2 +/- 3.3 mmol/l (p < 0.01) and from 13.3 +/- 3.6 to 11.1 +/- 3.0 mmol/l (p < 0.02) 1 and 2 hours after the load test, respectively. There was a significant reduction in the total area under the glycemic curve (S)--from 1583.5 +/- 405.8 to 1375.7 +/- 320.1 mmol/l x rmin. However, there were no significant changes. There was a significant increase in the relative value OS(1/2) from 51.7 +/- 17.7 to 62.8 +/- 20.0% and a significant reduction in OS2/S. Analysis of the area in relative values (OS(1/2) and OS2/S) obviates the ambiguousness of the results obtained when analyzing the area in absolute values. CONCLUSION: Glibenclamide treatment causes a statistically significant reduction in fasting and postprandial plasma glucose levels, glycated hemoglobin, and relative area values during the standard breakfast test.