Effect of glipizide treatment on postprandial lipaemia in patients with NIDDM

Abstract

SummaryThe primary goal of the present study was to examine the effects of improved glycaemic control associated with glipizide treatment on postprandial lipaemia in non-insulin-dependent diabetic patients. The metabolism of triglyceride-rich lipoproteins of intestinal origin was assessed by measuring the retinyl palmitate content in plasma and the Svedberg flotation index (Sf) > 400 and Sf 20-400 lipoprotein fractions. Fasting plasma glucose concentrations (14.5 + 0.5 vs 9.0 + 0.5 mmol/1), glycated haemoglobin levels (13.1 + 0.6 vs 9.7 _+ 0.6 %), and daylong plasma glucose concentrations were all significantly lower after glipizide treatment (p < 0.001). The improvement in glycaemic control was associated with increases in insulin-mediated glucose uptake (p < 0.001) and plasma post-heparin lipoprotein and hepatic lipolytic activities Go < 0.02). Both fasting plasma triglyceride (3.09 + 0.51 vs 2.37 + 0.34 mmol/1), and postprandial triglyceride concentrations (p < 0.05-0.001) were lower following glipizide treatment, associated with a significant fall in retinyl palmitate content in all three lipoprotein fractions (p < 0.02-0.001), with the most substantial decrease seen in the Sf 20-400 fraction. These data indicate that glipizide-induced improvement in glycaemic control was associated with changes in the metabolism of triglyceride-rich lipoproteins of intestinal origin that would be anticipated to reduce risk of coronary heart disease in non-insulin-dependent diabetic patients. [Diabetologia (1994) proteins of intestinal origin were higher in patients with NIDDM [2]. In 1979 Zilversmit [3] suggested that triglyceride-rich lipoproteins of intestinal origin, especially the cholesteryl ester-rich chylomicron remnants, could play a very important role in atherogenesis, and since then, several reports have been published supporting this hypothesis [4][5][6][7][8][9][10]. Thus, our observation that postprandial lipaemia was increased in NIDDM raised the possibility that abnormalities in the metabolism of intestinally-derived lipoproteins may contribute to the increased risk of CHD in these patients. Although we could not detect any correlation in our earlier paper between the magnitude of postprandial lipaemia and the level of glycaemic control, the crosssectional nature of the study protocol was not designed to carefully explore such a relationship. Consequently, we initiated the current study to see if improved glycaemic control associated with glipizide

Lack of Effect of Acute Repaglinide Administration on Postprandial Lipaemia in Patients with Type 2 Diabetes Mellitus

“…This was attributed to an increase in the activity of lipoprotein lipase. Similar results were obtained with glipizide (Jeppesen et al, 1994). Lipoprotein lipase is the key enzyme in the metabolism of both intestinally and hepatically derived triglycerides.…”

Effect of sitagliptin therapy on postprandial lipoprotein levels in patients with type 2 diabetes

“…In fact, many different oral hypoglycaemic agents have been shown to improve postprandial lipaemia, although this is not a universal finding. Both metformin [46,47] and glipizide [48] can improve postprandial lipid levels in poorly controlled type 2 diabetic patients, presumably by improving glycaemic control and reducing insulin resistance. However, the secretagogues nateglinide and glibenclamide had no significant impact on postprandial lipaemia, despite their associated insulinotropic effect and improvement in glycaemic control [49].…”

Effects of nateglinide and glibenclamide on postprandial lipid and glucose metabolism in type 2 diabetes

“…However, the risk of hypoglycemic side effects is higher in these subjects. On the other hand, in diabetic patients with poor glycemic control a significant improvement in glucose control can attenuate both fasting and postprandial dyslipidemia 22.…”