Interaction of Ethanol and Glipizide in Humans

Abstract

The hypoglycemic effect of 2.5 mg glipizide and the potentiation of this effect by ethanol were studied in 10 normal-weight nondiabetic subjects. The reductions in blood glucose concentrations were similar in time of onset and extent (2 mM) whether glipizide was taken alone or in combination with ethanol. However, the return of blood glucose toward fasting level was delayed by ethanol. Beta-Cell secretory activity, evaluated from the concentrations of insulin and C-peptide, was unchanged by ethanol. The serum glipizide concentrations were reproducible within subjects, whereas there was a considerable interindividual variation. This heterogeneity in the rise in glipizide concentration was strongly correlated with blood glucose fall and insulin secretion. Thus, ethanol can prolong but does not augment the hypoglycemia induced by glipizide. The heterogeneity in glipizide concentration seems to be caused by an interindividual variation in kinetics.

Practical strategies to normalize hyperglycemia without undue hypoglycemia in type 2 diabetes mellitus

“…However, the exact mechanism responsible for this is unclear because hormonal counterregulation seems to be relatively intact in type 1 [ 32 ] and type 2 patients [ 33 ] while they drink alcohol. Alcohol may have an important interaction with sulfonylureas to slow blood glucose recovery in response to hypoglycemia-a fact that should be discussed with patients on these drugs [ 34 ]. Smoking seems to increase the risk of hypoglycemia as well, at least in patients with type 1 diabetes [ 35 ].…”

Optimal management of type 2 diabetes in patients with increased risk of hypoglycemia

“…These factors include administering too much insulin or insulin-producing medications, delayed or missed meal intake or eating a smaller meal than planned, unplanned strenuous exercise, alcohol consumption, and interactions with other drugs. Patient-specific risk factors are also recognized to increase the risk of hypoglycemia, including advanced age, nutritional status, long duration of diabetes, renal or hepatic disease (may alter the metabolism or excretion of medications), and a history of previous hypoglycemic episodes 20–24…”

Sulphonylurea dose–response relationships: relation to clinical practice

“…in drug‐metabolizing capacity[1], and some to environmental factors, e.g. smoking and intake of charcoal‐broiled food, alcohol habits, protein–carbohydrate intake, and drug interactions[2–4].…”