[Attempted suicide using glibenclamide--also a contribution to the characterization of sulfonylurea effect].
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Biomedical subjects
Publications and source records attributed to E Haupt.
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Pharmacodynamic studies were performed with two new blood glucose lowering sulfonamides of high potency: gliquidone and gliflumide. The aim was to obtain equipotent doses on the basis of a maximum 30% blood glucose decrease in healthy normals (Ed 30) in order to compare the new compounds with the well known effects of tolbutamide and glibenclamide. Our investigations demonstrated a dose dependent blood glucose decrease with each sulfonylurea corresponding with the insulin levels after intravenous application. Gliquidone revealed a "tolbutamide-typed" dynamic both on insulin secretion and on blood glucose decrease whereas gliflumide showed a "glibenclamide-typed" reaction. The delayed and more prolonged insulin decrease, well known for glibenclamide, was even more distinct following gliflumide. Differences of insulin secretion after sulfonulureas can be observed only under intravenous conditions. Following oral application an only small increase of insulin can be noted when measured in peripheral blood.
The benefits of professional advice on dietetics in the medical practice can, at present, not be measured directly. They can only be assessed indirectly on a model basis using drugs savings as the benefit's indicator. If for example those some 880,000 diabetics of the Federal Republic of Germany who are treated with oral antidiabetic drugs and suffer from overweight would lose weight as a consequence of dietetic consultation, they could save at least 1 pill per day of a blood glucose lowering sulfonamide or biguanide derivate. This equals about 131 million DM p.a. If only 10 percent of 1000 diabetics under the advice of one assistant dietician would lose weight--in about 20 percent of all dietetic consultations such a success can be expected--this would cover the cost of such consultation.--In fact, in a sample of 228 diabetics with overweight, who received intensive advice on weight reduction, 85 percent were successful in losing weight, improved their metabolism, and therefore needed less antidiabetic drugs. They thus achieved annual cost savings about equal to an assistent dietician's salary. Thus, the employment of assistant dieticians in the medical practice is an advantage also from the economic point of view, and should be made possible for all practitioners interested.
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