THE EFFECTS OF TOXIC AND NON-TOXIC SERUM PHENYTOIN LEVELS ON CARBOHYDRATE TOLERANCE AND INSULIN LEVELS

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Abstract
The effect of toxic [serum levels > 20 .mu.g/ml] and non-toxic phenytoin levels on carbohydrate tolerance and insulin levels was studied in 18 patients with epilepsy and 17 control subjects. Toxic levels occurred in 11 patients and non-toxic levels in 7 patients. Blood glucose and insulin levels were measured at 30 min intervals for a period of 3 h following ingestion of 50 g glucose. Blood glucose levels were measured by the ferricyanide method, and serum insulin levels by insulin immunoassay with insulin antibody precipitate. Serum phenytoin levels were measured by GLC. Insulin profiles were the same for all 3 groups, but there was a significant delay in reaching peak glucose concentrations in patients with toxic phenytoin levels. Apparently non-toxic levels of phenytoin did not affect carbohydrate tolerance or insulin levels when phenytoin was used in the routine treatment of epilepsy. Toxic phenytoin levels did not affect carbohydrate tolerance when high levels were detected at an early stage.