Research Reports - Influence of glibenclamide on outcome in patients with type 2 diabetes and traumatic brain injury

Clin Neurol Neurosurg. 2013 Aug 17

Ding J, Yuan F, Guo JY, Chen H, Tian HL

BACKGROUND AND PURPOSE: The influence of sulfonylurea receptor 1 (SUR1) and its
inhibitor glibenclamide on progressive secondary hemorrhage (PSH), progressive
hemorrhagic necrosis (PHN), and brain edema has been studied in rat models of
traumatic brain injury (TBI) and ischemia. These studies indicate that blocking
SUR1 may exert protective effects in terms of outcome.
METHODS: We discuss the effects of glibenclamide on outcome in patients with type
2 diabetes mellitus and TBI. We collected demographic, clinical, and imaging data
from the clinical records of TBI patients with type 2 diabetes who were admitted
to the neurosurgery department at Shanghai 6th People's Hospital between 2001 and
2012. Data from patients who met the inclusion criteria were analyzed. Patients
were divided into glibenclamide group and insulin group.
RESULTS: Of 70 patients fit criteria for inclusion, no significant difference was
observed except for age and fasting plasma glucose between the two groups.
Outcome indicators, including GCS discharge, GOS discharge, length of study in
hospital (LOS-H), and the presence of PSH showed no significant difference too
(p>0.05), except for length of stay in neuro-intensive care unit (LOS-NICU)
(p<0.05). Age, hours between the initial CT scan and the injury (HCT1) and GCS at
admission were observed as factors associated with PSH after logistic regression.
CONCLUSIONS: In general, the use of glibenclamide to control plasma glucose after
TBI had no significant effect on patient outcome at discharge but it could reduce
the LOS-NICU (p<0.05). Glibenclamide also had no apparent effect on the presence
of PSH in TBI patients with type 2 diabetes mellitus.

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