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To the Editor: We published a study demonstrating that the hypoglycemic effect of maximal doses of once-daily second-generation sulfonylureas is minimal when administered to elderly subjects with type 2 diabetes during a prolonged fast.¹ However, the issue of whether immediate-release sulfonylureas have increased hypoglycemic potential during such a fast remains controversial. Because comparative studies have shown that fasting and postprandial serum insulin concentrations are increased following immediate-release glipizide administration compared with glipizide gastrointestinal therapeutic system (GITS) administration, we investigated whether the risk of hypoglycemia is increased in elderly patients with type 2 diabetes taking immediate-release glipizide compared with glipizide GITS during a prolonged fast.²

Methods.

Twenty-six subjects with type 2 diabetes treated with sulfonylureas who participated in our previous study were enrolled using previously described inclusion and exclusion criteria.¹ All participants gave informed consent for the protocol as previously described.

On enrollment, study participants received immediate-release glipizide (20 mg daily: 15 . . . [Full Text of this Article]

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