Phenethyl-, Amyl-, and Isoamylbiguanide in the Treatment of Diabetes Mellitus

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Abstract
In 1926, Frank et al.1synthesized Synthalin A (decamethylenediguanidine) and showed that oral administration of the drug lowered the blood sugar remarkably in partially depancreatized animals and in human diabetics. A few diabetic patients were treated with Snythalin A, but it was subsequently proved to be quite toxic even in small doses,2,3producing histological changes in the liver and kidney after one or two days, and all clinical use of the drug was discontinued. However, other compounds containing this guanidine group (Fig. 1) were not so toxic. Indeed, it is known that normal body constituents such as creatine and arginine contain the guanidine group. Also, Paludrine [N1-(p-chlorophenyl)-N5-isopropylbiguanide] has a mild hypoglycemic action, and it has been used successfully for several years in the treatment of malaria.12,13 Recently, in a search for hypoglycemic compounds, Ungar4found that phenethylformamidinyliminourea (also referred to as phenethyldiguanide, or DBI, but preferably called phenethylbiguanide, or PEBG)

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