ORIGINAL ARTICLE doi: 10.1111/j.1463-1326.2006.00690.x Cardiovascular, metabolic and hormonal responses to the progressive exercise performed to exhaustion in patients with type 2 diabetes treated with metformin or glyburide M. R. Cunha, 1,2 M. E. R. Silva, 1,2 H. A. Machado, 1,2 R. T. Fukui, 1 M. R. S. Correia, 1 R. F. Santos, 1,2 B. L. Wajchenberg, 1,2 D. M. Rocha, 1,2 M. U. P. B. Rondon, 3 C. E. Negra ˜o 3 and M. J. M. Ursich 1,2 1 Laboratory of Medical Investigation LIM-18, Hospital das Clinicas – University of Sa ˜o Paulo Medical School 2 Endocrine Service, Hospital das Clinicas – University of Sa ˜o Paulo Medical School 3 Heart Institute (InCor), Hospital das Clinicas University of Sa ˜o Paulo Medical School, Sa ˜o Paulo, Brazil Objectives: To evaluate the effects of Metformin and Glyburide on cardiovascular, metabolic and hormonal parameters during progressive exercise performed to exhaustion in the post-prandial state in women with type 2 diabetes (T2DM). Design and Methods: Ten T2DM patients treated with Metformin (M group), 10 with Glyburide (G group) and 10 age- paired healthy subjects exercised on a bicycle ergometer up to exercise peak. Cardiovascular and blood metabolic and hormonal parameters were measured at times -60 min, 0 min, exercise end, and at 10 and 20 minutes of recovery phase. Thirty minutes before the exercise, a standard breakfast was provided to all participants. The diabetic patients took Metformin or Glyburide before or with meal. Results: Peak oxygen uptake (VO 2 ) was lower in patients with diabetes. Plasma glucose levels remained unchanged, but were higher in both diabetic groups. Patients with diabetes also presented lower insulin levels after meals and higher glucagon levels at exercise peak than C group. Serum cortisol levels were higher in G than M group at exer- cise end and recovery phase. Lactate levels were higher in M than G group at fasting and in C group at exercise peak. Nor epinephrine, GH and FFA responses were similar in all 3 groups. Conclusion: Progressive exercise performed to exhaustion, in the post-prandial state did not worsen glucose control during and after exercise. The administration of the usual dose of Glyburide or Metformin to T2DM patients did not influence the cardiovascular, metabolic and hormonal response to exercise. Keywords: carbohydrate metabolism; exercise; oral pharmacological agents; other hormones/action Received 17 June 2006; returned for revision 1 October 2006; revised version accepted 4 October 2006 Exercise of moderate intensity in type 2 diabetes (T2DM) decreases glycaemia, indicating a beneficial effect of exer- cise on glucoregulation in such patients [1,2]. In contrast, hyperglycaemia has been reported during and after intense exercise [3]. With increasing emphasis on fitness and competitive sports, more diabetic individuals are engaging in intense physical activity [1]. However, very little research has been done in persons with T2DM [4–6]. Therefore, is essential, to evaluate cardiovascular, metabolic and hormonal responses to intense exercise along with its interaction with hypoglycaemic medications in patients with T2DM. Glyburide and metformin are frequently prescribed to these patients. Glyburide exerts its hypoglycaemic effect by inhibiting ATP-sensitive potassium (K ATP ) channels, stimulating the insulin secretion from pancreatic b cells Correspondence: Maria Rosa ´ria Cunha, Endocrine Service, Hospital das Clinicas – University of Sa ˜o Paulo Medical School, Maria Figueiredo 230, apto 101, 04002-000 Sa ˜o Paulo, SP, Brazil. E-mail: maria_cunha@uol.com.br 238 j Diabetes, Obesity and Metabolism, 10, 2008, 238–245 # 2007 The Authors Journal Compilation # 2007 Blackwell Publishing Ltd