Plasma protein binding of lidocaine and warfarin in insulin-dependent and non-insulin-dependent diabetes mellitus.
We examined the plasma protein binding of an acidic drug (warfarin bound to albumin) and a basic drug [lidocaine (lignocaine) bound to alpha 1-acid glycoprotein] in 15 patients with insulin-dependent diabetes mellitus (IDDM) and 15 matched controls. We also examined protein binding of warfarin and lidocaine in 30 patients with non-insulin-dependent diabetes (NIDDM) and 25 controls. Compared with control, the binding of both warfarin (98.81 +/- 0.02 vs 98.57 +/- 0.03%, mean +/- SEM) and of lidocaine (69 +/- 2 vs 58 +/- 2%) was significantly reduced in IDDM. This group had lower concentrations of both albumin and alpha 1-acid glycoprotein (AAG), achieving statistical significance vs control for albumin only. In the patients with NIDDM, who had a similar level of glycosylated haemoglobin, while there was no significant difference in the binding of lidocaine there was a significant increase in warfarin binding compared with the control population (99.01 +/- 0.03 vs 98.82 +/- 0.04%). This study suggests that binding of both acidic and basic drugs is altered in both IDDM and NIDDM.
O'Byrne
S
S
Department of Pharmacology, Trinity College Medical School, St James's Hospital, Dublin, Ireland.
Barry
M G
MG
Collins
W C
WC
O'Connor
P
P
Cullen
M J
MJ
Feely
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001798:Blood Proteins / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003956:Dialysis; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008012:Lidocaine / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011485:Protein Binding; D014859:Warfarin / Q000097:blood*
D001798:Blood Proteins; D006442:Glycated Hemoglobin; D008012:Lidocaine; D014859:Warfarin