Effects of gliclazide and insulin therapy on thromboxane B2 and 6- keta-PGF(1?) levels in type II diabetic patients

Diabetic patients show hemobiological abnormalities such as increased platelet adhesiveness, platelet hyperaggregability, decreased platelet half life, hemorheological abnormalities and altered fibrinolysis, perhaps contributing to a procoagulative state. Gliclazide, a novel sulfonylurea in routine clinical use, was thought to have effects on prostanoid release and platelet function. We studied thromboxane A2 metabolite; serum thromboxane B2 (TXB2) and the prostacyclin metabolite, 6-keto-PGF(1?) to assess the efficacy of gliclazide on these parameters. Two groups of age and sex matched type II diabetics were examined in the study. There were 16 subjects in each group (F:M = 10/6). The study period was 12 weeks. Gliclazide was given to the first group and insulin to the second. Following parameters were evaluated to see the effect of good control. HbA1c, cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, serum TXB2, 6-keto-PGF(1?) levels were measured before and after 3 months of therapy. There was no significant change in TXB2 (2.24 ± 0.2 to 2.08 ± 0.4 nmol/L) and 6-keto- PGF(1?) (2.53 ± 0.2 to 2.15 ± 0.1 nmol/L,) levels in patients treated with insulin despite the amelioration in the HbA1c levels. Therapy with gliclazide was followed by a significant decrease in both serum TXB2 levels (4.18 ± 0.7 to 2.72 ± 0.4, p = 0.039) and 6-keto-PGF(1?) (2.97 ± 0.3 to 2.03 ± 0.1, p = 0.0047). TXB2/6-keto-PGF(1?) ratio did not change both after insulin (1.09 ± 0.5 to 1.06 ± 0.8) and gliclazide (1.31 ± 0.9 to 1.32 ± 0.4) treatment. According to the datas in our study, gliclazide therapy decreased TXB2 levels as well as 6-keto-PGF(1?) levels so that ratio of TXB2/6-keto-PGF(1?) did not change, which would mean that gliclazide has neutral effect on diabetic microvascular complications