Wide variation in serum chlorpropamide concentration in outpatients.
Serum chlorpropamide concentrations (s-CPA) were determined and related to clinical findings in 83 outpatients with maturity onset diabetes. The daily doses of CPA (mg/kg) varied six-fold, but s-CPA ranged 18-fold between the patients. There was a significant correlation between dose and s-CPA (r = 0.61), which rose to 0.75 in the 30 patients who had prescribed no other drugs. Patients given other drugs concomitantly were over-represented amongst subjects with extreme values of apparent plasma clearance of CPA. There was no correlation either between serum creatinine or age and s-CPA. Of the 83 patients 40 (48%) had acceptable blood and urinary glucose values according to our criteria; but as 17 were overweight, only 23 patients (28%) had acceptable clinical control. Of the remaining 60 patients, too low a dose was being given to only 12, and dietary failure was the most probable explanation in the others. Thirteen patients (16%) probably did not need CPA. It is likely that this is a partial explanation for the high utilisation of oral antidiabetic drugs in Sweden. There was no general correlation between dose or s-CPA and blood glucose values, but analysis of s-CPA may still be of value in explaining unexpected changes in clinical control.
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002747:Chlorpropamide / Q000008:administration & dosage / Q000097:blood*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006029:Glycosuria / Q000652:urine; D006801:Humans; D007206:Individuality; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D010045:Outpatients; D010349:Patient Compliance
D001786:Blood Glucose; D002747:Chlorpropamide