INCREASED INSULIN SENSITIVITY AND CELLULAR INSULIN BINDING IN OBESE DIABETICS FOLLOWING TREATMENT WITH GLIBENCLAMIDE

The effect of glibenclamide on the insulin receptors, the insulin sensitivity and the insulin secretion in obese non-ketotic diabetics were examined. Two groups of 9 obese diabetics were studied before and after 10 days'' treatment with a 1200 kcal diet and a 1200 kcal diet + 10 mg/day of glibenclamide, respectively. In the group treated with diet alone no significant alteration of the insulin secretion pattern (P > 0.1) was found. The insulin sensitivity increased 37% (P < 0.01). The insulin binding to monocytes increased (P < 0.01) due to a 36% rise of the binding affinity. In the group treated with glibenclamide and diet the insulin secretory pattern was unchanged, too (P > 0.1). The insulin sensitivity increased 83% (P < 0.01). Moreover, the insulin binding was raised (P < 0.01) as a result of a 80% rise of the number of insulin receptors. In 4 patients who were treated with diet (1200 kcal/day) plus glibenclamide and in 5 patients who were treated with diet alone (1200 kcal/day) the insulin binding to monocytes was studied during treatment for 1 yr. After 1 yr. a significantly (P < 0.05) higher cellular insulin binding was found in the glibenclamide treated patients compared to the patients who received diet alone. The augmentation of the insulin sensitivity is of great importance for the normalization of the diabetic state in obese, the increase in insulin binding may be of importance for the increase in insulin sensitivity and glibenclamide appears to enhance the insulin sensitivity through an increase in the number of insulin receptors.