Sudden Death in a Diabetic Subject During Treatment with BZ-55 (Carbutamide)

Abstract

Two juvenile diabetics (previously reported 2 ) age 13 and 15, were studied on the metabolic ward simultaneously. The degree of severity of their diabetes was similar and their programs were identical in a quantitative chemical sense. Insulin was gradually withdrawn until both were spilling approximately 100 gm. of urinary sugar per day. Carbutamide was then added in doses ultimately reaching 16 gm. per day. Figure 6 shows the results in both boys. The first was responsive to the large dosage used. The second showed increased glycosuria without a concomitant increase in blood sugar, suggesting a renal effect. During this study it was noted that the responsive youngster was excreting the carbutamide mostly in the acetylated form, in contrast to the nonresponsive boy in whom the major portion of the drug was present in the free form. Further studies which we hope will throw light on this variation are in progress. SUMMARYWe have reported some of our experiences with two oral sulfonylurea compounds in sixty ambulatory diabetics. The drugs were effective in approximately 75 to 80 per cent of the cases and side effects were not a serious problem. Initial experiences with an intravenous sodium tolbutamide response test suggest that it is of little value in predicting which patients will be responsive.The diabetic glucose tolerance test of one nine-yearold boy was changed to normal by small doses of carbutamide. In another juvenile there was no change in the curve while on the drug. Balance studies in two hospitalized diabetics were paradoxical in that, while on identical programs one youth was responsive, the other, unresponsive. REFERENCES 1 Splitter, Thomas Stanford; Brown, Frederic L., Jr.; Friskey, Roger; Grindel, Lois; Kinsell, L. W.: Observations on diabetics treated with carbutamide and tolbutamide. California Medicine, in press.

Oral Treatment of Diabetes

“…Also in patients with diabetes and acromegalia caused by intra-sellar tumours, varying successes were seen. In some cases the trial was successful with sulphonylureas (MOHNIKE and STOTTER; MOORHOUSE and KARK;BREDNOW and J ORKE;FIELD and FEDERMAN;LACHNIT and TRETEN-HAHN;BERGENSTAL et al 1957). Other authors saw no effect of the sulphonylureas in diabetics with acromegalia (MOHNIKE and STOTTER; BARTELHEIMER and MARING;FAJANS et al 1956;FIELD and FEDERMAN, an own unpublished case).…”

Drug-induced cardiomyopathies

“…Myocarditis as a result of hypersensitivity to other drugs has been noted with chloramphenicol (446)(447)(448)(449), chlortetracycline (450), streptomycin (451), carbutamide (452), and phenylbutazone (453). Penicillin sensitivity has been found to result in cardiomyopathies.…”