Comparison of the effect of two different hypoglycemic agents, glibenclamide and HB 699, on the rat small intestinal absorption of sugars and amino acids.

4-(2-[5-Chloro-2-methoxy-benzamido]-ethyl)-benzoic acid (HB 699) belongs to the group of hypoglycemic benzoic acid derivatives. Although lacking the sulfonylurea group, the structure of HB 699 partly resembles that of glibenclamide which is known to impair small-intestinal glucose absorption in vitro at high concentrations. Whereas this intestinal effect of glibenclamide is unlikely to contribute to its blood-glucose lowering properties, extrapancreatic and particularly intestinal effects may be important for the antidiabetic action of HB 699. Thus, HB 699 was compared with glibenclamide for the effect on the small-intestinal absorption of sugars and amino acids in vitro (everted-sac and tissue-accumulation technique) and in vivo (single-pass perfusion of the jejunum). In vitro both drugs inhibited the active transport of sugars and amino acids in a dose dependent manner. At equieffective doses (HB 699, 4.5 mmol/l and glibenclamide, 1 mmol/l) the mode of inhibition by the two drugs was similar. A 30-min incubation period reduced the uptake of methyl alpha-D-glucoside by about 75%. The degree of inhibition depended on the time of exposure of the tissue to the drugs. In vitro kinetic studies revealed a mixed type of inhibition. The in vivo effect of the drugs was in accordance with the in vitro findings. Inhibition, as in vitro, was not reversible and even increased further after reinfusion of a drug-free perfusate. In vivo, the drugs inhibited the absorption of methyl alpha-D-glucoside and leucine only at low (less than 20 mmol/l) but not at high (greater than 30 mmol/l) solute concentrations. These results indicate that hypoglycemic benzoic acid derivatives may exert their blood-glucose lowering properties in part by impairing the small-intestinal active transport of glucose.