Effect of pioglitazone on insulin secretion in patients with both impaired fasting glucose and impaired glucose tolerance.

AIM: To evaluate the effect of a thiazolidinedione, pioglitazone, on insulin secretion in patients with both impaired fasting glucose and impaired glucose tolerance. METHODS: A randomized, double-blind, placebo-controlled clinical trial was carried out in 18 overweight or obese patients with both impaired fasting glucose and impaired glucose tolerance. Pharmacological intervention consisted of an oral morning administration of pioglitazone (30 mg) or a placebo with a similar presentation for 30 days. Before and after the intervention, glucose, creatinine, lipid profile and uric acid concentrations were measured. To evaluate insulin secretion (early, late and total phases) and insulin sensitivity, a hyperglycemic-hyperinsulinemic clamp was also performed. RESULTS: There were significant reductions (p=0.008) in fasting insulin concentration (121 versus 45 pmol/l), late (565 versus 307 pmol/l) and total insulin secretion (474 versus 254 pmol/l), as well as, in 2h postload glucose levels (9.7 versus 6.9 mmol/l, p=0.028), with an increment in insulin sensitivity after pioglitazone administration (7.5 versus 9.9). CONCLUSION: Pioglitazone administration during a period of 4 weeks decreased late and total insulin secretion phases, fasting insulin and 2h postload glucose levels, and improved insulin sensitivity in patients with both impaired fasting glucose and impaired glucose tolerance.

Effect of tequila on homocysteine, insulin secretion, insulin sensitivity, and metabolic profile in healthy men.

AIM: The purpose of this study is to identify the effect of a low dose of tequila on homocysteine, insulin secretion, insulin sensitivity, and metabolic profile in healthy young men. METHODS: An open clinical trial was carried out in eight healthy nonobese, young male volunteers. The study was divided in two phases. The first one evaluated metabolic changes, including insulin secretion and sensitivity due to acute administration of 30 ml of straight tequila. The second phase of the study evaluated metabolic effects due to the daily administration of 30 ml of tequila during 30 days. RESULTS: There were no significant metabolic changes after the single oral administration of 30 ml of straight tequila. After the administration of tequila during 30 days, a significant increase in homocysteine levels and a tendency to increase the glucose concentration and to decrease the insulin sensitivity were found. CONCLUSION: Detrimental metabolic changes were observed with the daily administration of 30 ml of tequila during 30 days.

Effect of celecoxib, a cyclooxygenase-2-specific inhibitor, on insulin sensitivity, C-reactive protein, homocysteine, and metabolic profile in overweight or obese subjects.

BACKGROUND: The aim of this study was to assess the effect of celecoxib, a cyclooxygenase- 2-specific inhibitor, on insulin sensitivity, C-reactive protein, homocysteine, and metabolic profile in overweight or obese subjects. METHODS: A randomized, double-blind, placebo-controlled clinical trial was carried out on 12 overweight or obese (body mass index, 25-35 kg/m(2)) male volunteers. Six subjects received celecoxib 200 mg orally in the morning for a period of 4 weeks. Six other individuals took a placebo for the same period of time, as the control group. Before and after the 4-week study period, insulin sensitivity, C-reactive protein, homocysteine levels, and metabolic profile were estimated. To assess insulin sensitivity, the euglycemic-hyperinsulinemic clamp technique was performed. RESULTS: There were no significant differences in the basal measurements between both groups. C-reactive protein, homocysteine, and metabolic profile were not modified by the pharmacologic intervention with placebo or celecoxib. The insulin sensitivity after celecoxib was significantly higher compared with the basal estimation (3.8 +/- 1.2 vs. 2.8 +/- 1.2 mg/kg/min; p = 0.028). The placebo did not modify the insulin sensitivity. CONCLUSIONS: The specific inhibition of the cyclooxygenase-2 by celecoxib increased the insulin sensitivity in overweight or obese subjects, without modification in C-reactive protein, homocysteine levels, and metabolic profile.