title: Sensitivity to enkephalin as a cause of non-insulin dependent diabetes.
abstract: Non-insulin-dependent diabetes is associated with facial flushing after alcohol in patients on chlorpropamide (chlorpropamide alcohol flushing, C.P.A.F.) especially when there is a family history of diabetes. C.P.A.F. in three subjects (two diabetics, one non-diabetic) was blocked by the specific opiate antagonist naloxone. In nine subjects (six diabetics) C.P.A.F. was reproduced by the enkephalin analogue with opiate-like activity [D-Ala2, MePhe4, Met (O)-ol] enkephalin (DAMME). C.P.A.F. thus may be due to increased sensitivity to endogenous opiates. DAMME and other substances with opiate-like activity, such as morphine and beta-endorphin, affect carbohydrate metabolism and insulin secretion. Increased sensitivity to endogenous opiates such as enkephalin may thus give rise to non-insulin-dependent diabetes associated with C.P.A.F.
mesh_terms: D000434:Alcoholic Beverages; D002747:Chlorpropamide / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D004336:Drug Antagonism; D004723:Endorphins / Q000276:immunology*; D004745:Enkephalins / Q000276:immunology* / Q000494:pharmacology; D005145:Face; D006728:Hormones / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000175:diagnosis; D009270:Naloxone / Q000494:pharmacology; D012881:Skin Temperature / Q000187:drug effects
chemical_list: D004723:Endorphins; D004745:Enkephalins; D006728:Hormones; D009270:Naloxone; D002747:Chlorpropamide