糖尿病者に於けるChlorpropamide静注試験 (Diabinese-Test) に対する考察

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The standard oral glucose tolerance test has been used for many years for the diagnosis of diabetes mellitus. In 1957, the intravenous tolubutamide response test and then the intravenous chlorpropamide response test were introduced as a complement to, or a replacement of, the glucose loading test. These are the test using the hypoglycemic action provoked by sulfonylureas for diagnostic purposes. In the present report we analyze the conclusion arising from the study of the glycemic curves obtained by the intravenous use of chlorpropamide. This test was done in 30 diabetic subjects and 5 normal subjects. After an overnight fasting, chlorpropamide was administered intravenously in dosis of 500mg dissolved in 5.2ml of physiologocal saline solution over a period of 2 minutes. Blood specimens were obtained before injection and at 20, 30, 40, and 60 minutes after the middle of the injection period. Bood sugar levels were determined by the method of Hagedorn-Jensen. The normal subjects showed glycemic curves with the following average percentage decrease with respect to initial values : after 20 minutes 25.4%, after 30 minutes 39.2%, after 40 minutes 21.4%, and after 60 minutes 10.4%.<BR>The diabetic subjects showed glycemic curves with the following average percentage decrease : after 20 minutes 4.3%, after 30 minutes 7.9%, after 40 minutes 10.6% and after 60 minutes 12.7%. There are separation at the level of 30% in glycemic decrease at 30 minutes and 20% at 20 minutes, and the values for the control subjects are above it and the values for the diabetics below it.<BR>Between the chlorpropamide response curves of "control type" and "diabetic type", there seems to be a net difference at 30 minutes. But from a discriminative viewpoint, in addition to the value at 30 minutes, it would be safer to concider the value after 20 minutes. These curves are a certain similarity between glycemic curve of response to insulin and glycemic curve that provoked by tolbutamide. None of the cases showed signs of reactions caused by hypoglycemia and other remarkable side effects. In the result, the intravenous chlorprpamide response test appears to have quality as a new diagnostic procedure for diabetecs mellitus, especially for mild diabetes.
日本内分泌学会の論文

糖尿病者に於けるChlorpropamide静注試験 (Diabinese-Test) に対する考察

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