The chlorpropamide alcohol flush test in diabetes mellitus: methods for objective evaluation

Area of Science:

• Endocrinology
• Metabolic Disorders
• Pharmacology

Background:

• The chlorpropamide alcohol flush (CPAF) response is a known indicator in type 2 diabetes.
• Objective assessment methods for CPAF are needed to improve diagnostic accuracy.

Purpose of the Study:

• To objectively evaluate the chlorpropamide alcohol flush (CPAF) test in type 2 diabetics.
• To compare facial skin temperature and plasma acetaldehyde levels with visible flush responses.

Main Methods:

• Standardized CPAF and alcohol challenge tests were administered to 137 type 2 diabetic patients.
• Facial skin temperature and plasma acetaldehyde levels were measured.
• Visible flush responses (flush/no flush) were recorded.

Main Results:

• A visible facial flush occurred in 53% of participants.
• Increased facial skin temperature (≥1.0°C) was observed in 90% of flushers versus 14% of non-flushers.
• Elevated plasma acetaldehyde (≥4 μmol/l) was found in 86% of flushers versus 15% of non-flushers.
• 78% of flushers met all three objective criteria, while 74% of non-flushers met none.

Conclusions:

• Facial skin temperature and plasma acetaldehyde measurements offer objective evaluation of the CPAF test.
• These methods enhance the reliability of CPAF assessment in type 2 diabetes.
• A small percentage (5%) of alcohol flushers showed a falsely positive CPAF test.