Disappearance Rate of Tolbutamide in Normal Subjects and in Diabetes Mellitus, Liver Cirrhosis, and Renal Disease

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Abstract
The disappearance rate of tolbutamide from the blood was not affected by the metabolic disorders of diabetes mellitus but was prolonged by severe hepatic or renal impairment. The half-life of tolbutamide had significant correlations both with glomerular filtration rate (GFR) measured by creatinine clearance and with serum nonprotein nitrogen concentration (NPN); an increase in half-life was associated with a decrease in GFR or an increase in NPN. Patients with liver cirrhosis sometimes revealed the changes in arterial blood glucose which were similar to those observed in patients with insulomas. However, such changes in arterial blood glucose were not attributable to the prolongation of half-life of tolbutamide. Renal patients with a proven prolonged half-life of tolbutamide did not reveal such changes.