Abstract
Serum glucose and insulin responses to oral acetohexamide (0.5 g), oral glucose (50 g, OGTT), and oral acetohexamide followed by oral glucose (Oral acetohexamide glucose tolerance test, OAGTT) were determined in 10 normal and 24 diabetic subjects, and following results were obtained:
(1) Following oral administration of acetohexamide, a slight in crease in serum insulin concentrations was observed in normal and diabetic subjects.
(2) With a less increase in serum glucose, the serum insulin concentrations in response to OAGTT were greater than those to OGTT in normal subjects.In diabetic subjects, the serum insulin concentrations were also increased in response to OAGTT in the satisfactory controlled group with acetohexamide. The impaired glucose tolerance was improved markedly. In the unsatisfactory controlled group, on the other hand, the serum glucose and insulin responses to OGTT did not change significantly by prior administration of acetohexamide.
(3) The improvement of impaired glucose tolerance by OAGTT was more clearly demonstrated by calculating the ratios of the increment of glucose to OAGTT (ΔGlucose-OAGTT) to that of OGTT (ΔGlucose-OGTT). The ratio was calculated to be less than 0.75 in the satisfactory controlled group and to be more than 0.75 in the unsatisfactory controlled group.
(4) When applied this ratio to the newly diagnosed diabetic subjects, the prediction for acetohexamide treatment was well matched with the results of clinical evaluation after treatment for 6 or more months.
These results indicate a possible mechanism of acetohexamide by increasing the sensitivity of β-cells to glucose stimulus. The oral acetohexamide glucose tolerance test might be employed as a convenient means of predicting for acetohexamide treatment in diabetic subjects.
