Effect of Insulin and Sulfonylurea Therapy, at the Same Level of Blood Glucose Control, on Low Density Lipoprotein Subfractions in Type 2 Diabetic Patients¹

Abstract

The aim of this study was to evaluate the effect of sc insulin (INS) compared with sulfonylurea (SUL) therapy, at the same level of blood glucose control, on the low density lipoprotein (LDL) subfraction profile in normolipidemic type 2 diabetic patients. Nine normolipidemic type 2 diabetic men (age, 56+/-3 yr; body mass index, 26.5+/-0.9 kg/m2; mean +/- SEM), after a 3-week wash-out period, were assigned to INS or SUL for 2 months in a randomized cross-over design. Doses were adjusted only during the first month and then were kept constant. At the end of the treatments, hemoglobin A1c, plasma lipids, LDL, and very low density lipoprotein (VLDL) subfraction profiles and plasma postheparin lipoprotein lipase and hepatic lipase (HL) activities were evaluated. Despite glucose control was similar at the end of both periods (hemoglobin A1c, 7.4+/-0.3% vs. 7.0+/-0.2%, INS vs. SUL), INS compared with SUL significantly reduced plasma triglyceride (0.9+/-0.1 vs. 1.1+/-0.1 mmol/L; P < 0.05). Although INS did not affect the LDL concentration, it induced a decrease in both the amount (59.0 = 9.8 vs. 76.1+/-16.8 mg/dL; P = NS) and the proportion (31.2+/-3.0% vs. 38.3+/-3.8%; P < 0.03) of small LDL. Moreover, the decrease in small LDL was positively related to the reduction of large VLDL (r = 0.67; P < 0.04) and HL (r = 0.69, P < 0.05) induced by insulin therapy. In conclusion, sc insulin therapy, independently of glucose control and even in the presence of quite low plasma triglyceride levels, is able to reduce small LDL particles in type 2 diabetic patients. This change is related to decreases in both HL activity and large VLDL particles.

The impact of various hypoglycemic modalities on endothelium dysfunction biomarkers in patients with T2DM

“…The present study showed no significant differences in BMI, marital status, or smoking between all groups, while diabetic patients need to consider the impact of obesity on developing microvascular complications. The present finding is supported by the Rivellese et al (2000) 26 study, which found no significant variation in the BMI being very similar at the end of each treatment period. In contrast, Doghish et al (2019) 12 found that the BMI of both patient groups was significantly different from the control group, but there was no significant difference between patient groups.…”

Impact of Pomegranate Juice, Antidiabetic Therapy on Glycemic Control and Lipid Subfraction Status

“…One study also observed an anti-diabetic effect on the erythrocyte membrane of diabetes mellitus individuals with alterations in glucose levels and lipid and phospholipid subtraction. 21 Many workers have observed lipid alterations in diabetes mellitus and hyperglycaemia, other metabolic alterations [40][41][42][43][44] This study demonstrated that pomegranate juice combined with an antidiabetic therapy regimen could provide additional benefits in glucose control. Phospholipids affect insulin action, ranging from altering gene expression linked to glucose absorption and affecting mitochondrial dynamics.…”