Effects of Tolbutamide and Insulin on Fructose and Glucose Metabolism in Diabetes Mellitus

Long-term Results in Treatment of Diabetes Mellitus with the Sulphonylureas

“…The dependence for success of these drugs on endogenous insulin has led to the hypothesis that they act either by augmenting the circulating insulin or by rendering it more effective. As against this, the experimental work has failed to demonstrate the concomita of an increased peripheral insulin effect, such as the fall in the serum phosphate, the rise in pyruvic-acid level, and the increase BRMH MDCAL JOURNAL in the arteriovenous glucose difference (Moorhouse and Kark, 1956;Purnell et al, 1956).…”

Xanthinuria

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Bm 1217 in the arteriovenous glucose difference (Moorhouse and Kark, 1956;Purnell et al, 1956).In a previous study we were unable to demonstrate by the rat-diaphragm technique any increase in the insulin-like activity of the serum in diabetic patients on tolbutamide treatment (Weaver et al, 1958). However, should the hypoglycaemic properties of sulphonylureas be due entirely to a depression of hepatic glycogenolysis, such an effect is probably manifest only if it is associated with some peripheral utilization of glucose, and hence the dependence on insulin.

The finding that males are less likely to respond than females might be expected from the results of Wrenshall and Hamilton (1957) on the levels of insulin extractable at post-mortem examination from the pancreas of diabetic subjects.

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Oral Hypoglycaemic Drugs

“…There is no doubt that tolbutamide reduces the output of glucose by the liver in humans and in dogs, during fasting and after fructose administration (Renold et al, 1956;Moorhouse et al, 1957) whether measured directly by means of catheterization studies or indirectly by the rate of fall of the specific activity of Ci4-labelled glucose (Ashmore, Cahill and Earle, I957;Tarding and Schambye, 1958;Miller et al, 1957;Purnell et al, 1956; Fischer, I957).…”