Plasma glucose response after intravenous injection of tolbutamide in insulin-treated type I and type II diabetic patients.

Abstract

To estimate the residual beta-cell function, plasma glucose and C-peptide response to an intravenous injection of tolbutamide were observed in seven Type I (insulin dependent) and nine Type II (non-insulin dependent) diabetic patients on insulin therapy. Fasting plasma glucose in the patient was controlled below 11 mmol/l by conventional insulin therapy, and 1 g of tolbutamide was intravenously injected. In the serum C-peptide response following tolbutamide injection, seven of nine Type II diabetics showed the peak values of serum C-peptide more than 0.3 nmol/l from 20 min to 60 min after the load, and Type I diabetics gained the peak values less than 0.3 nmol/l except one patient. The decrease of plasma glucose within 60 min after tolbutamide injection was more than 20% of the basal level in eight of nine Type II diabetics, and in all of seven Type I diabetics the decrease did not exceed 15%. Both serum C-peptide and plasma glucose after tolbutamide load responded differently between Type I and Type II diabetics on insulin therapy, and it was thought that tolbutamide load-glucose response test may be a useful method to estimate the residual beta-cell function in the diabetics.