Nine weeks of bedtime diazoxide is well tolerated and improves β‐cell function in subjects with Type 2 diabetes

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Abstract
To test whether a bedtime dose of diazoxide can improve daytime beta-cell function without side-effects in Type 2 diabetes. A double-blind randomized study was performed in 27 Type 2 diabetic subjects (17 male, 10 female) who were treated with bedtime insulin and metformin. Subjects received either bedtime diazoxide, 100 mg, or placebo for 9 weeks. Duplicate C-peptide glucagon tests were performed before and in the last days of intervention. No side-effects of diazoxide were detected. Treatment with diazoxide did not incur any increase in bedtime insulin. C-peptide responses to glucagon tended to increase: 0.15 +/- 0.06 nmol/l vs. -0.01 +/- 0.04 nmol/l for placebo, P < 0.06 for difference. Corresponding effects on insulin were 66.2 +/- 41.7 pmol/l for diazoxide vs. -84.2 +/- 51.5 for placebo, P < 0.03. Treatment with diazoxide decreased fasting glucagon levels by 41% vs. placebo, P < 0.03. Glycated haemoglobin (HbA1c) levels were not affected, whereas levels of blood glucose post breakfast were higher during diazoxide (1.34 +/- 0.43 mmol/l, P < 0.01 vs. placebo). Bedtime treatment with diazoxide in Type 2 diabetic subjects on bedtime insulin and metformin has no significant side-effects, does not increase bedtime insulin supplementation, tends to ameliorate beta-cell function but fails to improve metabolic control.