Influence of glisoxepide with and without butylbiguanide on the serum insulin level

In a crossover study the behavior of immunoreactive insulin (IRI) and blood sugar was examined in 20 maturity onset diabetics receiving as monotherapy 1 (hexahydro 1 H azepin 1 yl) 3 {p [2 (5 methylisoxazol 3 carboxamido) ethyl] phenyl sulfonyl} urea (glisoxepide, BS 4231, Pro Diaban) and in combination with BS 5892 (Sindiatil). The patients were each given 4 wk treatment with 12 mg BS 4231, and with 6 mg BS 4231 plus 200 mg BS 5892. Whereas the fasting IRI values did not differ substantially, following primary sulfonylurea monotherapy accompanied by a rise from 33 μU/ml fasting to a maximum of 121 μU/ml (371%), there was no significantly (p = 0.05) higher insulin secretion after 2 hr than after the combined therapy, during which the IRI fasting value of 32 μU/ml rose merely to a maximum of 81 μU/ml (256%). If, however, combined therapy was given prior to the sulfonylurea monotherapy, no statistically significant difference was found from a comparison of the maximum insulin secretion rates. In the parallel estimated blood sugar values no considerable differences occurred in the 2 groups.