Über ein wirksames perorales Antidiabeticum (BZ 55)

Zusammenfassung

Im BZ 55 — N₁-sulfanilyl-N₂-n-butyl-carbamid — liegt das erste, sicher wirksame perorale Antidiabetikum vor, das — anscheinend ohne Nebenwirkungen— zum mindesten beim Gegenregulations-Diabetes eine eindeutige Verbesserung der Stoffwechselbilanz herbeiführt. Eine exakte diätetische Behandlung ist, ebenso wie bei der Insulintherapie, unbedingte Voraussetzung für einen Behandlungserfolg. Da über den Wirkungsmechanismus, die Indikationsbreite, die optimale Dosierung und mögliche Nebenwirkungen des Mittels noch keine ausreichenden Erfahrungen bestehen, wird eine allgemeine Anwendung des BZ 55 erst nach weiteren ausgedehnten Prüfungen, die an mehreren Kliniken im Gange sind, zu verantworten sein.

Summary

A new hypoglycaemic drug, sulfanilyl-n-butyl-urea (BZ 55) was used in 82 patients with diabetes mellitus of differing severity and duration of illness. All had been carefully observed for some time. Frequent blood sugar determinations, glucose tolerance tests and urine examinations were performed before and during the trial period. BZ 55 was administered in tablets containing 0.5 Gm. of the drug. Five tablets were given on the first day, 3 on the second, and 2 daily thereafter. At this (and even higher) dosage, young diabetics showed practically no response. But elderly ones had remarkable results. One group, consisting of 28 patients between the ages of 49 and 77 years who had been inadequately treated or not at all, showed the best therapeutic response. All but 3 showed a rapid decrease of blood sugar levels to below 150 mg.%. In several patients the drug could even be discontinued after 10 days without relapse during a further observation period of 3 months, as long as strict diet was maintained. If relapse occurred, renewal of treatment was again successful. Response in 3 patients with mild acidosis was poor, despite high doses. Evidently, the drug is not suitable for sudden metabolic disturbances. Another group of 38 patients, between the ages of 41 and 77, had previously been on insulin, some for many years. Complete replacement of insulin was achieved in 28. No harmful or unpleasant side-effects were ever observed. The mode of action is thought to be on the α-cells of the pancreas by decreasing their production of hyperglycaemic, insulin-antagonistic substance. It is stressed that further careful studies are still needed, before routine use of the drug can be recommended in the elderly diabetic.

Resumen

Sobre un medicamento antidiabético eficaz de administración peroral

Se considera el BZ 55 - sulfanilil-n-butil-urea — como la primera sustancia de acción antidiabética eficaz que, al parecer sin efectos secundarios, es capaz de mejorar el balance metabólico, al menos en la diabetes por contraregulación. Análogamente a lo que sucede con la terapéutica insulínica, es premisa necesaria para el éxito terapéutico el cuidadoso tratamiento dietético. Puesto que no se tiene todavía una experiencia suficiente acerca del mecanismo de acción, zona manejable, dosis óptima y posibles efectos secundarios del medicamento, no debe utilizarse en gran escala el BZ 55 hasta que se lleven a cabo otras comprobaciones que se están realizando ya en varias Clínicas.