Midaglizole (DG-5128), 2-[2-(4,5-dihydro-1H-imidazol-2-yl)-1-phenylethyl]
pyridine dihydrochloride sesquihydrate, is a new type of oral
antidiabetic agent that has an alpha 2-adrenoceptor-antagonizing effect. As previously reported,
midaglizole reduces plasma
glucose, mainly by stimulation of insulin secretion, and inhibits
epinephrine-induced platelet aggregation in normal human subjects. In this study, the clinical safety and efficacy of short-term administration of
midaglizole were evaluated in 47 patients with
non-insulin-dependent diabetes mellitus (
NIDDM). After an observation period on diet or sulfonylurea treatment (1 patient was on
insulin), patients received 150-250 mg 3 times a day of
midaglizole for 2-4 wk, (some patients continued treatment for greater than 4 wk). In 20 of the patients first treated with diet and then switched to
midaglizole treatment, fasting plasma
glucose (FPG) decreased significantly from 187 +/- 10 mg/dl (mean +/- SE) to 147 +/- 13 mg/dl (P less than .05) and 120 +/- 6 mg/dl (P less than .01) 2 and 4 wk, respectively, after administration of
midaglizole.
Glycosylated hemoglobin (
HbA1) also decreased from 12.0 +/- 0.7 to 11.3 +/- 1.1 and 10.7 +/- 0.6% after 2 and 4 wk, respectively. In 23 of the patients whose treatment was changed from sulfonylureas to
midaglizole, FPG, and
HbA1 levels were maintained at the same values obtained before administration of
midaglizole. In patients treated with
midaglizole for greater than 12 wk, FPG and
HbA1 were kept at the lowered levels.(ABSTRACT TRUNCATED AT 250 WORDS)