Robinson D S, Nilsson C M, Leonard R F, Horton E S
J Clin Pharmacol. 1981 Nov-Dec;21(11):637-46. doi: 10.1002/j.1552-4604.1981.tb05676.x.
The effects of two loop diuretics, bumetanide and furosemide, on carbohydrate metabolism and electrolyte balance were assessed in 11 normal male subjects in a double-blind manner. Glucose, insulin, glucagon, and growth hormone responses to 5-hour glucose tolerance test and arginine infusion were measured during the control and drug treatment periods. Three other non-insulin-dependent diabetic subjects, receiving diuretic drug for six weeks, underwent a similar protocol. Kaliuresis and natriuresis due to diuretic administration were significant only on day 1 of treatment. There were no significant changes in total body potassium by 40K counting; net potassium loss by balance study was minimal in both the acutely treated subjects and the chronically treated patients. Effects of bumetanide and furosemide on water and electrolyte excretion did not differ. Glucose tolerance was significantly improved with bumetanide but not with furosemide. Plasma insulin, glucagon, and growth hormone levels during the oral glucose tolerance test were unaffected by either drug. Insulin levels with arginine infusion were significantly increased, and growth hormone levels decreased with bumetanide but not with furosemide. No evidence of impaired carbohydrate metabolism in the three chronically treated diabetic subjects was seen. It is concluded that the effects of bumetanide and furosemide on potassium balance and glucose utilization were minimal in this experimental setting.
以双盲方式在11名正常男性受试者中评估了两种袢利尿剂布美他尼和呋塞米对碳水化合物代谢及电解质平衡的影响。在对照期和药物治疗期测量了对5小时葡萄糖耐量试验和精氨酸输注的葡萄糖、胰岛素、胰高血糖素及生长激素反应。另外三名接受利尿剂治疗六周的非胰岛素依赖型糖尿病受试者也进行了类似的方案。利尿剂给药引起的尿钾增多和尿钠增多仅在治疗第1天显著。通过40K计数，全身钾无显著变化；无论是急性治疗的受试者还是慢性治疗的患者，通过平衡研究得出的净钾损失均极小。布美他尼和呋塞米对水和电解质排泄的影响无差异。布美他尼可显著改善葡萄糖耐量，而呋塞米则无此作用。口服葡萄糖耐量试验期间的血浆胰岛素、胰高血糖素和生长激素水平均不受两种药物的影响。精氨酸输注时胰岛素水平显著升高，布美他尼可使生长激素水平降低，而呋塞米则无此作用。未观察到三名慢性治疗的糖尿病受试者有碳水化合物代谢受损的证据。得出结论，在本实验环境中，布美他尼和呋塞米对钾平衡和葡萄糖利用的影响极小。
