Chlorpropamide,* a New Drug for Diabetes Mellitus: Clinical Studies

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SINCE 1942, when sulfonylurea derivatives were found to have hypoglycemic action, a large number of related compounds have been developed and are being used in diabetic patients. The most recent of these is chlorpropamide.*1–7

The basic molecular structure of chlorpropamide is similar to that of other sulfonylureas, but the addition of a chlorine atom has made the action of the drug more prolonged. In man, the plasma concentration of chlorpropamide has decreased by one half in approximately 36 hours,8, 9 whereas that of tolbutamide has decreased by one half in four hours.10 As a result, considerably smaller doses of chlorpropamide will achieve concentrations of blood sulfonylurea and hypoglycemic action similar to that of tolbutamide.

This report is a summary of clinical studies during the last six months of 1958 of 53 patients with diabetes mellitus.

Material and Methods

Our clinical study of 53 diabetic patients consisted of three parts: trial of chlorpropamide in (1) 31 adult patients with stable diabetes, (2) four elderly patients with unstable diabetes, and (3) 18 young patients with diabetes.

Adult, stable diabetics. The 31 patients were selected for chlorpropamide therapy because they were candidates for tolbutamide therapy. They all had the so-called “stable” (onset at maturity) diabetes. They were between 32 and 81 years of age. Sixteen patients previously were well maintained on daily doses of from 10 to 52 units of insulin. Eight patients previously had received tolbutamide therapy up to 2 gm. daily, but in two, there was primary, and in six, . . .



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