The natural history of treated Cushing's syndrome.
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Biomedical subjects
Publications and source records attributed to D A Montgomery.
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In an initial trial of glibenclamide in the treatment of maturity onset diabetes mellitus 28 patients were treated for up to one year and no toxic effects or side-effects were encountered. The hypoglycaemic potency of this drug is such that 5 mg. of glibenclamide corresponds to about 1,500 mg. of tolbutamide and 375 mg. of chlorpropamide.
A cardiovascular study of a group of 90 newly diagnosed diabetic women aged 35 to 75 years was begun in 1965 and a repeat examination was carried out on the same patients in 1968. A high prevalence of ischaemic heart disease was found in these patients at the time of diagnosis, and this finding had some predictive value as regards prognosis over the three-year period.A comparative study with general medical outpatients and long-established diabetics (greater than 10 years' duration of disease) confirmed the high prevalence of ischaemic heart disease in late-onset mild diabetics controlled by diet or oral drugs. It is suggested that this type of milder diabetic patient contributes in undue proportion to the high prevalence of ischaemic heart disease in diabetes.
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The circadian rhythms of preprandial and postprandial blood glucose, free fatty acids, and insulin levels were measured in groups of normal and of diabetic patients controlled by diet alone or by diet with tolbutamide, chlorpropamide, or metformin. All groups showed a greater insulin release after the first meal of the day than after subsequent meals. Diabetic patients controlled for more than two years on diguanide therapy showed the closest resemblance to non-diabetic control subjects. There was no significant difference between the values for diabetic patients on long-term control with diet alone and those on short- or long-acting sulphonylurea. The circadian rhythms disappeared in obese subjects on total starvation.
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