Circadian Variations of Carbohydrate Tolerance in Maturity Onset Diabetics Treated with Sulfonylureas

Abstract
Fourteen maturity onset diabetics treated either with tolbutamide, glibornuride or chlorpropamide were given 3 equal meals at 08.00, 12.00 and 17.30. Capillary blood sugar (BS), plasma insulin (IRI) and free fatty acids (FFA) were determined at frequent intervals during a 48-hour test period. In all groups studied the blood sugar increase observed after breakfast and supper was significantly higher than the one found after lunch. Nadir blood sugar values were reached in the late afternoon. The increase of carbohydrate tolerance observed at noon may be attributed to higher IRI and lower FFA values obtained before lunch as compared to values found before breakfast and supper. Plasma concentrations of human growth hormone (HGH) determined in 5 patients did not correlate with circadian variations of carbohydrate tolerance. Practical implications of the results obtained for dietary management are discussed.

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