Chlorpropamide-alcohol flushing in non insulin-dependent diabetes: Prevalence of small and large vessel disease and of risk factors for angiopathy

Abstract

One hundred and eight non insulin-dependent diabetics were tested for alcohol flushing after chlorpropamide administration (CPAF test). The overall prevalence of patients who flushed at the first challenge was 32%. However, nearly half of them still flushed after alcohol administration, when placebo was given instead of chlorpropamide, so that the prevalence of 'true' flushers was only 17%. Even though the distribution of retinal lesions was similar in 'true' flushers and in non flushers, severe loss of visual acuity was confined to the non flushers and aspecific flushers. The frequency of pathological ECG findings and of peripheral pulse reduction or abolition was significantly higher in the non flushers and aspecific flushers. Blood pressure, serum lipids and hemostatic parameters were similar in the two groups, and therefore do not explain the differences in prevalence of lesions. This study confirms the previous findings of a lower prevalence of large vessel lesions in flushers; however, the prevalence of 'true' CPAF phenomenon in our out-patient population appears to be much lower than previously reported.

Chlorpropamide ? alcohol flush: the case in favour

“…The relative freedom from complications has been confirmed by some [25] but not by others [26]. The apparent discrepancy may be due to different doses of chlorpropamide being used to elicit the reaction.…”

Aldehyde Dehydrogenase Activity and Large Vessel Disease in Diabetes Mellitus: A Preliminary Study

“…23 Soon several conflicting reports appeared, some supporting the original observations, 45 others casting doubt on the issue. 6 The discrepancies could partly be explained by lack of objective methods to study the flush, and by differences between the populations studied. 7 The biochemical basis of the flush has been studied in order to find a clue to the possible relationship between CPAF and vascular complications.…”