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Twelve weeks’ treatment with diazoxide without insulin supplementation in Type 2 diabetes is feasible but does not improve insulin secretion
Author(s) -
Radtke M.,
Kollind M.,
Qvigstad E.,
Grill V.
Publication year - 2007
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2006.02056.x
Subject(s) - diazoxide , medicine , bedtime , insulin , type 2 diabetes , endocrinology , metformin , crossover study , hypoglycemia , glucagon , diabetes mellitus , placebo , alternative medicine , pathology
Aims Treatment with K‐ATP channel openers, such as diazoxide, can have beneficial effects on insulin secretion in both Type 1 and Type 2 diabetes. However, the precise conditions for obtaining beneficial effects without untoward events have not been determined. We tested the hypothesis that intermittent administration of diazoxide at bedtime for 12 weeks could produce beneficial effects in the absence of side‐effects in Type 2 diabetic patients who were not taking insulin. Methods After an 8‐week run‐in period, during which treatment with repaglinide and metformin was optimized, we randomized 26 patients to either diazoxide, 100 mg at bedtime, or placebo. Results Side‐effects were absent or minimal. HbA 1c did not change. However day‐time glucose concentrations by home glucose monitoring were ∼1.5 mmol/l higher with diazoxide vs. placebo. Stimulation tests (C‐peptide‐glucagon and breakfast) did not indicate improved pancreatic B‐cell function, except by posthoc analysis, in a subgroup of younger age. Conclusion Compared with previous results with diazoxide together with bedtime insulin, the present results are less favourable and indicate that concomitant insulin treatment is needed during intervention with K‐ATP channel openers.