Summary
Despite better control of diabetic patients the 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 having 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 orin vitro this does not necessarily apply to human diabetics.
References
Gonen B., Rubenstein A. H.: Haemoglobin Al and diabetes mellitus - Diabetologia15, 1, 1978.
Hadden D. R., Montgomery D. A. D., Weaver J. A.: Myocardial infarction in maturity onset diabetes - Lancet1, 335, 1972.
Harrower A. D. B., Clarke B. F.: Experience of coronary care in diabetes - Brit. med. J.1, 126, 1976.
Kannel W. B., McGee D. L.: Diabetes and cardiovascular risk factors: The Framingham Study - Circulation59, 8, 1979.
Lasseter K. C., Levey G. S., Palmer R. F., McCarthy J. S.: The effect of sulphonylurea drugs on rabbit myocardial contractility, canine Purkinje fiber automaticity and adenyl cyclase activity from rabbit and human heart - J. clin. Invest.51, 2429, 1972.
Linden J., Brooker G.: The positive inotropic action of sulfonylureas. A mechanism independent of cyclic adenosine 3′,5′-monophosphate - Diabetes27, 694, 1978.
Miller A. M., Hannan W. J., Sapru R. P., Muir A. L.: An evaluation of six kits of technetium 99mhuman serum albumin injections for cardiac blood pool imaging - Europ. J. nucl. Med.4, 91, 1979.
Palmer R. F., Lasseter K. C., McCarthy J.: Tolbutamide: an inotropic effect on rabbit atria - Lancet1, 694, 1971.
Pell S., D'Alonzo C. A.: Factors associated with long term survival of diabetics - J. Amer, med. Ass.214, 1833, 1970.
Pogátsa G., Dubecz E.: The direct effect of hypoglycaemic sulphonylureas on myocardial contractile force and arterial blood pressure - Diabetologia13, 515, 1977.
Soler N. G., Pentecost B. L., Bennet M. A., Fitzgerald M. G.: Coronary care for myocardial infarction in diabetics - Lancet1, 475, 1974.
The University Group Diabetes Program: A study of the effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes - Diabetes19 (Suppl. 2), 789, 1970.
Young J. L. Jr.,Burr I. M., Perry J. M., Nelson J. H., Nies A. S.: Inotropic effect of tolbutamide in man - Amer. Heart J.89, 189, 1975.
Young K. C., Railton R.: Inter-observer variation in estimates by nuclear angiography of left ventricular ejection fraction and ejection rate - Brit. J. Radiol.53, 585, 1980.
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Harrower, A.D.B., Adam, R.D., McFarlane, G. et al. The effect of the acute administration of tolbutamide on left ventricular function in insulin-dependent diabetics. Acta diabet. lat 18, 385–388 (1981). https://doi.org/10.1007/BF02042823
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DOI: https://doi.org/10.1007/BF02042823