misoprostol and Diabetes-Mellitus--Type-2

To determine the efficacy of the prostaglandin E1 analogue misoprostol in the treatment of tinnitus in diabetic and/or hypertensive patients.. Double-blind, randomized, placebo-controlled trial.. Tertiary care referral center.. The subjects were 42 patients with hypertension and/or diabetes mellitus who had chronic tinnitus and had experienced tinnitus symptoms for a minimum of 6 months. Twenty-eight patients were randomly assigned to Group I (misoprostol treatment), and 14 patients to the Group II (placebo treatment). Misoprostol therapy was started at 200 microg per day, and was increased 200 microg every 7 days until a dose of 800 microg per day was reached. The same numbers of placebo tablets were given to the control group using the same schedule. Both groups were treated for 1 month. The changes in objective and subjective tinnitus findings from baseline to 1 month were assessed, and the group results were compared. The chi(2)-test, student's t-test and paired-samples t-test were used to analyze the study.. At the completion of treatment, objective assessment showed that tinnitus loudness decreased in 13 (46%) of the 28 patients in the experimental group, whereas this was observed in only two (14%) of the 14 subjects in the placebo group. Subjective tinnitus scoring revealed improvement rates of 29 and 14% for the misoprostol and placebo groups, respectively. When t-test relating to difference between rates were performed, the difference between improvement rate for tinnitus loudness of the experimental group and control group was found to be statistically significant (P = 0.05), but difference between improvement rate based on subjective tinnitus scoring was insignificant (P = 0.22).. Misoprostol is an effective and safe treatment for chronic tinnitus in hypertensive and/or diabetic patients. Our results are encouraging, but further studies of larger series are needed.

Topics: Adult; Aged; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Double-Blind Method; Female; Humans; Hypertension; Male; Middle Aged; Misoprostol; Severity of Illness Index; Tinnitus

In vitro and in vivo studies have demonstrated that prostaglandins of the E series enhance muscle glucose uptake. We examined the effect of acute misoprostol (PGE1) administration on whole body insulin-mediated glucose disposal, as well as the major intracellular pathways of glucose metabolism in type 2 diabetic (n = 10) and non-diabetic (n = 4) subjects. Each subject received two 240-min euglycaemic insulin (40 mU/m2/min) clamp studies with tritiated glucose and indirect calorimetry. During one of the insulin clamp studies, 200 microg of misoprostol was ingested at 90 and 150 min after the start of the insulin infusion. Insulin-mediated total body glucose disposal, glycolysis, glycogenesis and glucose oxidation were similar during the insulin clamp studies performed without and with misoprostol in both the diabetic and non-diabetic groups. These results demonstrate that the acute administration of misoprostol does not enhance insulin-mediated glucose disposal in either type-2-diabetic or non-diabetic subjects.

Topics: Blood Glucose; Body Mass Index; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Diabetes Mellitus, Type 2; Female; Glucose Tolerance Test; Glycated Hemoglobin; Humans; Insulin; Male; Metabolic Clearance Rate; Middle Aged; Misoprostol; Reference Values; Triglycerides

The aim of the study was to investigate whether oral application of misoprostol (MI), which is an analogue of prostaglandin E1, does change the secretion of insulin and the blood glucose level. The investigations were carried out in 15 subjects, aged 21-40 yrs, with a gastric or duodenal ulcer and without any disturbances of the digestive tract motility. In 7 of them (group A), without stated diabetes a single oral dose of 400 mg MI versus placebo (PL) and 15 min later 75 g glucose p.o., was applied in randomized order, on different days, in fasting state. In 8 subjects with mild diabetes type II (gr B) MI versus PL and after 15 min. i.v. 1.0 mg glucagon was similarly administered. In both groups the concentrations of glucose and C-peptide in blood were determined. In comparison to PL, the application of MI did not cause any statistically significant differences of C-peptide in serum and blood glucose levels neither before and after oral glucose loading nor after i.v. administration of glucagon. Statistically not significant were also the differences in AUC (p > 0.05).

Topics: Adult; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 2; Duodenal Ulcer; Glucagon; Humans; Male; Misoprostol; Radioimmunoassay; Stomach Ulcer