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Insulin secretion in patients with diabetes insipidus during long-term treatment with chlorpropamide.

ABSTRACT Intravenous glucose tolerance tests were performed in 15 control subjects and 8 patients with neurohypophyseal diabetes insipidus (DI) who were effectively treated for an uninterrupted period of 2–6 yr with the sulphonylurea derivate chlorpropamide. The glucose assimilation coefficient (K value) in the control group was 1.60 ± 0.09 (± sem) and the maximal plasma immunoreactive insulin (IRI) concentration was 70 ± 9 μU/ml (sem). TWO DI patients had low K values, 3 patients had normal K values, and 3 patients had K values higher than the control K value + 2x the standard deviation. In 3 patients normal IRI concentrations were found. In the remaining 5 patients extremely high plasma IRI levels were obtained (peak values 4 to 5 times above the peak values obtained in the control subjects). It is suggested that longterm treatment with chlorpropamide in nondiabetic subjects can result in hypertrophy of the pancreatic β-cells which secrete increased amounts of readily available IRI. The fact that in the...