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HIGH GLIPIZIDE DOSES DO NOT IMPROVE GLUCOSE CONTROL.
Physicians commonly increase the dosage of oral sulfonylurea drugs when low doses do not adequately lower blood glucose. Yet surprisingly little is known about the relation between dose and response to these drugs. These researchers assessed the effect of escalating doses of glipizide in 23 non-insulin-dependent diabetic patients.
Each patient's glycemic control was determined during a 2-week placebo period and three subsequent 3-month periods during which they took 10, 20, or 40 mg of glipizide per day, in random order. Mean home-monitored glucose measurements were significantly improved during glipizide therapy as compared with the placebo period. However, blood glucose and hemoglobin A1C measurements were no better with 20 or 40 mg of glipizide than with the 10-mg dose. Insulin and glucose responses to a test meal did not improve with increasing glipizide doses.
These results show that dose escalation offers no added benefit for at least one sulfonylurea drug. The authors suggest considering insulin therapy for patients who have no response to moderate doses of sulfonylurea.
— ASB
Published in Journal Watch General Medicine February 9, 1993
Citation(s):
Stenman S et al. What is the benefit of increasing the sulfonylurea dose. Ann Intern Med 1993 Feb 1 118 169-172.
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