Effects of low dose versus conventional dose @entity2740 diuretic on insulin action in essential XXXX .

@entity1 @entity101 @entity6 @entity3592 @entity412 @entity2740 @entity972 @entity413 @entity165
OBJECTIVE: To see whether low dose @entity2740 diuretics given to @entity1 with essential @entity101 might avoid the adverse metabolic consequences seen with conventional doses. DESIGN: Double blind randomised crossover study of two 12 week treatment periods with either low dose (1.25 mg) or conventional dose (5.0 mg) @entity3592 given after a six week placebo run in period. SETTING: Outpatient clinics serving the greater Belfast area. SUBJECTS: 16 white non- @entity6 @entity1 (9 male) under 65 with essential @entity101 recruited from general practices within the greater Belfast area. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure and peripheral and hepatic insulin action. RESULTS: One @entity1 failed to complete the study. There were no differences between doses in their effects on systolic and diastolic blood pressure. @entity3592 1.25 mg had substantially less effect on serum @entity972 concentration than the 5.0 mg dose. There were no intertreatment differences in fasting @entity413 , insulin, @entity165 , and @entity412 concentrations. @entity3592 5.0 mg significantly increased postabsorptive endogenous @entity413 production compared with baseline (mean 10.9 (SD 1.2) v 10.0 (0.8) mumol/kg/min), whereas @entity3592 1.25 mg did not. Postabsorptive endogenous @entity413 production was significantly higher with @entity3592 5.0 mg compared with 1.25 mg (10.9 (1.2) v 9.9 (0.8) mumol/kg/min) but was suppressed to a similar extent after insulin ( @entity3592 5.0 mg 2.8 (1.5) mumol/kg/min v @entity3592 1.25 mg 2.2 (1.5) mumol/kg/min). Exogenous @entity413 infusion rates required to maintain euglycaemia were not significantly different between doses and were similar to baseline. CONCLUSIONS: @entity3592 1.25 mg is as effective as conventional doses but has less adverse metabolic effect. In contrast with conventional doses, low dose @entity3592 has no effect on hepatic insulin action. There is no difference between low and conventional doses of @entity3592 in their effect on peripheral insulin sensitivity.
