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The effect of the acute administration of tolbutamide on left ventricular function in insulin-dependent diabetics
Insights
Acute intravenous tolbutamide did not affect left ventricular ejection fraction in Type-1 diabetic patients. This suggests oral hypoglycemic agents may not adversely impact cardiac function in humans, despite concerns from animal studies.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Diabetic patients exhibit higher heart disease morbidity and mortality.
- Potential causes include accelerated atherosclerosis or primary diabetic cardiomyopathy.
- Adverse cardiac effects of oral hypoglycemic agents require investigation.
Purpose of the Study:
- To investigate the acute cardiac effects of tolbutamide in Type-1 diabetics.
- To assess the impact of intravenous tolbutamide on left ventricular ejection fraction (EF).
Main Methods:
- Nuclear angiography was used to measure left ventricular ejection fraction (EF).
- Ten Type-1 diabetic patients received 1g of intravenous tolbutamide.
- Ten diabetic patients received intravenous saline as a control group.
Main Results:
- No significant difference in EF response was observed between the tolbutamide group and the saline control group.
- Acute intravenous administration of tolbutamide did not impair cardiac function in this cohort.
Conclusions:
- Intravenous tolbutamide does not appear to have acute adverse cardiac effects in Type-1 diabetic patients.
- Findings contrast with potential adverse effects observed in animal or in vitro studies.
- This suggests that the cardiac safety profile of oral hypoglycemic agents in humans may differ from preclinical data.
Abstract:
Despite better control of diabetic patients with morbidity and mortality from heart disease is significantly higher than in non-diabetics. While this may be a result of premature atherosclerosis or primary diabetic cardiopathy, the possibility of oral hypoglycemic agents have adverse cardiac effects must be considered. Using nuclear angiography the effect of the acute administration of 1 g tolbutamide on left ventricular ejection fraction (EF) in a group of 10 Type-1 diabetics was investigated. There was no difference in the response of the EF when compared to the response in 10 diabetic controls given i.v. saline. While i.v. tolbutamide may have adverse cardiac effects when administered to animals or in vitro this does not necessarily apply to human diabetics.