Lactic acidosis occurring during phenformin therapy.
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Biomedical subjects
Publications and source records attributed to A Bloom.
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Forty-one diabetic patients on insulin were given 100mg. of phenformin daily for six weeks, either before or after a period of six weeks of inert capsules, in a double-blind cross-over trial. Eleven patients while on phenformin noticed hypoglycaemic effects and reduced their insulin on average by almost 20% without resultant rise in blood sugar levels. Twenty-eight patients felt no untoward effects and maintained their usual insulin dose. Phenformin led to improved control of the diabetes, with a significant decrease in blood sugar levels and a significant reduction in the variability of the weekly blood sugar readings. There was no increased ketosis, no change in cholesterol, and no significant loss of weight.
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One hundred and seventy-six patients who were newly referred to two diabetic clinics completed an initial questionnaire and a second questionnaire 1 yr later. Over the 1-yr period the average 2-h postprandial blood sugar was reduced from 13.8 to 8.8 mmol/L. The questionnaire included 33 questions on symptoms, and four symptoms improved by more than 10%: increased thirst (reduced by 29%), dry mouth (reduced by 24%), pruritus (17%), and weakness in the limbs (10%). No symptom was increased by more than 7%. The changes in five symptoms were significantly related to the changes in blood sugar observed, the improvement in symptoms being associated with reductions in blood sugar. These results are contrasted with newly referred hypertensive patients in whom marked improvements in symptoms were not observed and an increased frequency of certain symptoms was observed owing to drug side effects.