2210-PUB: Nonselective Mineralocorticoid Receptor Antagonist May Alter Morning Elevation of Plasma Glucose Levels after Waking

Previously, we reported that morning plasma glucose (PG) elevation before wake-up(W1) and after wake-up(W2), occur through different mechanisms in patients with type 2 diabetes. We measured three point PGs by Point-of-Care Testing (POCT) and flash glucose monitoring system (FreeStyle Libre Pro™); midnight (3 am), the time of awakening (about 6 am) and just before breakfast (8 am), hormones and their metabolites in 32 hospitalized patients with type 2 diabetes. Those with insulin therapy or overtly elevated fasting PG (>11 mmol/L) were excluded. W1 could be explained by relative insulin deficiency. Urinary normetanephrine, reflects a sum of production of norepinephrine was significantly correlated with W2 (R=0.422, p0.05). The Urinary normetanephrine was increased by the treatment (0.19±0.19 mg/gCre to 0.26±0.11 mg/gCre, p0.05). Further, eplerenone(50mg), a selective mineralocorticoid receptor antagonist affected neither W1 nor W2 in 2 male diabetes patients with hypertension. These results suggested that nonselective mineralocorticoid receptor antagonist may affect glucose metabolism via change of alpha-adrenergic tone. Disclosure K. Yamauchi: None.