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  • 1
    ISSN: 1432-0428
    Keywords: Phenformin ; metformin ; glibenclamide ; blood glucose ; lactate ; alanine ; pyruvate ; ketone bodies ; maturity-onset diabetes ; diabetic control ; gluconeogenesis ; glycerol ; insulin ; triglycerides ; growth hormone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twelve hour metabolic rhythms have been performed on six maturity-onset diabetic subjects during successive periods of therapy with phenformin, metformin, and glibenclamide. Moderate control of blood glucose concentration was achieved with phenformin and metformin, the lowest concentrations being found with glibenclamide. Mean blood lactate concentration was grossly elevated during phenformin therapy, moderately elevated with metformin and normal during glibenclamide treatment. Similar patterns were found for the lactate/pyruvate ratio, alanine, glycerol and ketone bodies. Serum triglyceride concentrations were significantly higher during phenformin treatment than with the other two regimes. Serum insulin concentration was higher on glibenclamide than with either biguanide. Most of these effects of the biguanides could be accounted for by an inhibitory effect on hepatic gluconeogenesis. It is concluded that the use of biguanides as hypoglycaemic agents in diabetes is associated with the production of multiple metabolic abnormalities.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Phenformin ; sulphonylureas ; blood glucose ; lactate ; pyruvate ; ketone bodies ; alanine ; glycerol ; non-esterified fatty acids ; growth hormone ; gluconeogenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twelve hour metabolic rhythms have been determined in two groups of subjects during combined therapy with a sulphonylurea and phenformin 50 mg twice daily. Subjects with clinical evidence of complications of diabetes showed greater abnormalities in concentrations of blood intermediary metabolites than a group of subjects without complications despite similar mean blood glucose concentrations in the two groups (7.6 mmol/l with complications; 7.3 mmol/l without complications). Mean blood lactate (1.93 mmol/l v 1.39 mmol/l), alanine (0.56 mmol/1 v 0.43 mmol/l), total blood ketone bodies (0.20 mmol/l v 0.14 mmol/l) and several other intermediary metabolites and their ratios were significantly higher in the group with diabetic complications. It is suggested that the differences between the two groups may arise from impaired disposal of phenformin leading to higher blood concentrations in the group with diabetic complications, despite normal liver function tests and plasma creatinine concentration. It is probable that this accumulation of phenformin results in more pronounced effect upon blood glucose and other intermediary metabolites. Thus, the metabolic abnormalities previously reported in patients treated by phenformin alone are also present during combined sulphonylurea and phenformin therapy, and in the presence of diabetic microangiopathy these abnormalities are accentuated.
    Type of Medium: Electronic Resource
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