Rachmiel Levine

Analysis of the Actions of the Hormonal Antagonists of Insulin

The actions of epinephrine, thyroxine, the glucocorticoids and the GH of the pituitary, which account for the varying degrees of insulin antagonism exhibited by these hormones, are discussed and illustrated. The possible sites of the contra-insulin effects are pictured in diagrams which depict the presently known schemes of intermediary metabolism.

Oral Hypoglycemic Agents: Panel Discussion

PRESIDENT REED: The panel will discuss some of the new oral hypoglycemic agents. I take this opportunity to introduce Dr. Arthur R. Colwell, St., of Northwestern University Medical School, who will moderate the program. DR. COLWELL: The release is imminent for general use of a sulfonamide compound which, when given by mouth, has unquestioned ability to lower blood sugar values both in normal and in many diabetic subjects. All are properly interested in several major points. How does the substance act? How should it be used in treatment? Are there risks in its use? What is its relationship, if any, to insulin? This panel will endeavor to provide answers to these and other questions. If there is disagreement among us it will reflect the difficulties which have been encountered in trying to find reliable answers to many important questions, particularly concerning mechanisms of action. A great deal of experimental and clinical data has been accumulated during the last two years or so concerning the sulfonylurea compounds. The experts at my side are well-informed concerning them and have contributed generously to their study. To start the discussion, I will ask each of the panelists to give us a brief orientation on certain aspects of the subject. For the most part, this will concern the sulfonylurea compounds, and specifically tolbutamide, which is marketed under the trade name of Orinase, the only compound available now clinically in this country. Dr. Root, will you give a brief historical background and identification of these compounds?