Benzothiadiazine suppression of insulin release from normal and abnormal islet tissue in man.

Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension

“…It has been suggested that the decrease in serum potassium levels might impair insulin secretion and inhibit muscle glucogen synthase activity, which is associated with a decrease in insulin-mediated uptake of glucose. 24,31 Our data clearly showed that the administration of ACE inhibitor did not ameliorate the adverse effects of diuretics in agreement with recently published data, which reported that combination therapy evoked hepatic insulin resistance when 5 mg of bendrofluazide was used. 26 Consequently, great care needs to be exercised in the use of these combinations notwithstanding that they are particularly efficacious in lowering BP, as it is also illustrated in the present study.…”

“…Interestingly, after both diuretics' treatment a significant increase in fasting and 2 h postload glucose levels was evident, while no significant change in both fasting and 2 h postload insulin levels was found, suggesting that diuretics could directly or indirectly (through hypokalaemia) decrease pancreatic insulin secretion. 24,25 Even though evaluation of insulin sensitivity using the euglycaemic glucose clamp technique was not performed in our study, it is noteworthy that no beneficial effect of perindopril on serum glucose and insulin levels both fasting and 2 h postloading relative to baseline was demonstrated. Thus, the putative beneficial effect of ACE inhibitors on carbohydrate metabolism remains controversial.…”

Insulinoma: Literature’s Review (2)

“…Patients with benign insulinomas have been managed successfully for up to 16 years with diazoxide in doses of 150 to 450mg/d in combination with trichlormethiazide in doses of 2 to 8mg/d. If they can be tolerated, higher doses may be used in patients with malignant insulinomas [58][59][60][61].…”

Furosemide decreases the sensitivity of glucose transport to insulin in skeletal muscle in vitro

“…Chronic administration of diuretics impairs glucose tolerance, but the mechanisms involved are uncertain (1)(2)(3)(4)(5)(6)(7)(8). Although a decrease in the secretion of insulin has been reported (4,8), additional mechanisms may be involved since these drugs cause hyperglycemia in pancreatectomized dogs or alloxan-diabetic mice (9).…”

“…Although a decrease in the secretion of insulin has been reported (4,8), additional mechanisms may be involved since these drugs cause hyperglycemia in pancreatectomized dogs or alloxan-diabetic mice (9). Skeletal muscle is quantitatively most important for glucose disposal in response to insulin (10).…”