Increased fibrinolytic potential induced by gliclazide in Types I and II diabetic patients
Article Abstract:
Diabetic patients have a greatly increased risk for vascular diseases such as coronary heart disease. Diabetes increases the lesions or damaged areas in blood vessels, initiating the process of vascular disease. One theory of how diabetes leads to vessel damage is that it increases fibrin deposition within vessels. Fibrin is a protein involved in blood clotting and when abnormally deposited in vessels, it clogs the vessels and impairs the ability of the damaged tissue to repair itself. Increasing fibrinolysis (the breakdown of fibrin) is one proposed method for preventing vascular disease in diabetic patients. Tissue-type plasminogen activator (t-PA) is a fibrinolytic agent that is widely used in the treatment of heart attack. Gliclazide is a sulfonylurea agent that is widely used in Europe to reduce blood glucose levels in patients with Type II diabetes. This study examined the effects of gliclazide on (t-PA)-related fibrinolysis in both Type I (insulin-dependent) and Type II (non-insulin-dependent) diabetes. Drug therapy was given to 23 Type I and 17 Type II diabetics for six months; blood samples were drawn at the beginning of the study and at various points during therapy to evaluate glycemic (blood sugar) control and fibrinolytic activity. The Type II diabetics were originally taking another drug (tolbutamide) before switching to gliclazide. Results showed that fasting blood glucose levels and other indicators of glycemic control remained constant in both groups throughout the study. Cholesterol levels continuously decreased, dropping from 5.90 millimoles per liter (mmol/L) to 5.41 mmol/L after 12 months of drug therapy. In the Type I diabetics, the concentrations of t-PA (as measured by t-PA antigen) increased significantly with treatment, but the concentrations of t-PA inhibitors did not change. In the Type II diabetics, active t-PA was not detectable in samples taken before the patients were started on gliclazide. Thereafter, active t-PA became detectable and increased significantly in concentration. The concentration t-PA inhibitor did not increased in the Type II group. These results indicate that gliclazide improves the fibrinolytic activity of t-PA in both Type I and Type II diabetics; this action is unrelated to its effect on insulin. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Diabetic retinopathy in non-insulin-dependent diabetes mellitus patients: the role of gliclazide
Article Abstract:
Retinopathy is a disease of the blood vessels of the retina of the eye that can lead to blindness. Diabetics have a much higher risk for developing retinopathy than the nondiabetic population. In diabetics who require insulin, more than 75 percent develop disease of the retina within 20 years of the onset of diabetes. Retinopathy is one of the results of the general microangiopathy (damage and clogging of very small blood vessels) that occurs in most diabetics. Laser treatment is available and can reduce the severity of retinopathy and prevent blindness. Preventative methods would be much preferred. Currently, such approaches involve maintaining glycemic (blood glucose) control. This helps prevent vascular disease to some degree in most diabetics, but treatments that directly address the development of vascular problems are needed. Gliclazide is a sulfonylurea drug that has been suggested for both glycemic control and directly affecting processes that lead to vascular disease. Studies have shown that gliclazide prevents platelet aggregation and enhances fibrinolytic activity, the breakdown of the fibrin. (Platelets and fibrin are involved in blood clotting.) Studies have evaluated the effectiveness of gliclazide in slowing the progression of retinopathy in diabetics. Results showed that this agent either slowed or reversed the progression of retinopathy. A more recent, long-term study examined the development and progression of retinopathy in diabetics treated for five years with gliclazide, other drugs, or diet therapy. Results indicated that gliclazide treatment did not prevent retinopathy from developing, but slowed its progression. Gliclazide appears to be effective in treating retinopathy in diabetics, but further studies are needed to assess its ability to prevent retinopathy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
User Contributions:
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