Summary
The aim of the present paper was to evaluate the prevalence of the chlorpropamide-alcohol-flush (CPAF) in patients with type 2 and with type 1 diabetes. Ninety-seven patients with type 2 diabetes and 33 with type 1 diabetes drank 40 ml vermouth 12 h after placebo and again 12 h after 1 tablet of chlorpropamide (250 mg) or 12 h after the last of repeated administrations of chlorpropamide (250 mg b.i.d. for 2 days). Skin temperature was recorded in all patients by a thermocouple probe connected to the left cheek. In 47 patients serum concentrations of chlorpropamide and of its metabolite CBSU were also determined. The prevalence of CPAF was similar in type 1 and type 2 diabetes, was greater in women than in men, and was significantly greater after repeated administrations than after one single administration of chlorpropamide. The increase of skin temperature during a 30-min period was significantly higher in patients with CPAF than in patients without CPAF. Serum concentrations of chlorpropamide and of its metabolite CBSU were more elevated after 4 than after 1 tablet of chlorpropamide, but were not significantly different in patients with and without CPAF. These data indicate that both genetic factors and the amount of chlorpropamide used affect the appearance of CPAF. To assess the possible role of serotonin and of dopamine in the CPAF, some patients with CPAF were tested again after treatment with metergoline, an antiserotonin agent, or with bromocriptine, a dopamine-agonist. Neither drug influenced the CPAF, indicating that the two neurotransmitters are not involved in the CPAF.
Similar content being viewed by others
References
Barnett A. H., Gonzalez-Auvert C., Pyke D. A., Saunders J. B., Williams R., Dickenson C. J., Rawlins M. D.: Blood concentrations of acetaldehyde during chlorpropamide-alcohol flush — Brit. med. J.ii, 939, 1981.
De Silva N. E., Tunbridge W. M. G., Alberti K. G. M. M.: Low incidence of chlorpropamide-alcohol flushing in diet-treated, non-insulin-dependent diabetes — Lanceti, 128, 1981.
Editorial: Bromocriptine, a changing scene — Brit. med. J.iv, 667, 1975.
FitzGerald M. G., Gaddie R., Malins J. M., O’Sullivan D. J.: Alcohol sensitivity in diabetics receiving chlorpropamide — Diabetes11, 40, 1962.
Fuxe K., Agnati L., Everitt B.: Effects of metergoline on central monoamine neurons. Evidence for a selective blockade of central 5-HT receptors — Neurosci. Letters1, 283, 1975.
Köbberling J., Bengsch N., Brüggeboes B., Schwarck H., Tillil H., Weber M.: The chlorpropamide-alcohol flush. Lack of specificity for familial non-insulin dependent diabetes — Diabetologia19, 359, 1980.
Leslie R. D. G., Pyke D. A.: Chlorpropamide-alcohol flushing: a dominantly inherited trait associated with diabetes — Brit. med. J.ii, 1519, 1978.
Leslie R. D. G., Pyke D. A., Stubbs W. A.: Sensitivity to enkephalin as a cause of non-insulin dependent diabetes — Lanceti, 341, 1979.
Medbak S., Wass J. A. H., Clement-Jones V., Cooke E. D., Bowcook S. A., Cudworth A. G., Rees L. H.: Chlorpropamide alcohol flush and circulating met-enkephalin: a positive link — Brit. med. J.283, 937, 1981.
Podgainy H., Bressler R.: Biochemical basis of the sulfonylurea induced antabuse syndrome — Diabetes17, 679, 1968.
Pyke D. A.: Diabetes: the genetic connections — Diabetologia17, 333, 1979.
Strakosch C. R., Jefferys D. B., Keen H.: Blockade of chlorpropamide alcohol flush by aspirin — Lanceti, 394, 1980.
Sved S., McGilveray I. J., Beaudoin S.: Assay of sulfonylurea in human plasma by high-performance liquid chromatography — J. pharm. Sci.65, 1356, 1976.
Taylor J. A.: Pharmacokinetics and biotransformation of chlorpropamide in man — Clin. Pharmacol. Ther.13, 710, 1972.
Van Loon G. R., De Souza E. B.: Effects of β-endorphin on brain serotonin metabolism — Life Sci.23, 971, 1978.
Van Loon G. R., Ho D., Kim C.: β-endorphin-induced decrease in hypothalamic dopamine turnover — Endocrinology106, 76, 1980.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pontiroli, A.E., De Pasqua, A., Colombo, R. et al. Characterization of the chlorpropamide-alcohol-flush in patients with type 1 and type 2 diabetes. Acta diabet. lat 20, 116–123 (1983). https://doi.org/10.1007/BF02624912
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02624912