Leslie R D, Pyke D A, Stubbs W A
Lancet. 1979 Feb 17;1(8112):341-3. doi: 10.1016/s0140-6736(79)92887-3.
Non-insulin-dependent diabetes is associated with facial flushing after alcohol in patients on chlorpropamide (chlorpropamide alcohol flushing, C.P.A.F.) especially when there is a family history of diabetes. C.P.A.F. in three subjects (two diabetics, one non-diabetic) was blocked by the specific opiate antagonist naloxone. In nine subjects (six diabetics) C.P.A.F. was reproduced by the enkephalin analogue with opiate-like activity [D-Ala2, MePhe4, Met (O)-ol] enkephalin (DAMME). C.P.A.F. thus may be due to increased sensitivity to endogenous opiates. DAMME and other substances with opiate-like activity, such as morphine and beta-endorphin, affect carbohydrate metabolism and insulin secretion. Increased sensitivity to endogenous opiates such as enkephalin may thus give rise to non-insulin-dependent diabetes associated with C.P.A.F.
非胰岛素依赖型糖尿病与服用氯磺丙脲的患者饮酒后面部潮红有关（氯磺丙脲酒精潮红，C.P.A.F.），尤其是当有糖尿病家族史时。三名受试者（两名糖尿病患者，一名非糖尿病患者）的C.P.A.F.被特异性阿片拮抗剂纳洛酮阻断。在九名受试者（六名糖尿病患者）中，具有阿片样活性的脑啡肽类似物[D-丙氨酸2，甲基苯丙氨酸4，甲硫氨酸（O）-醇]脑啡肽（DAMME）重现了C.P.A.F.。因此，C.P.A.F.可能是由于对内源性阿片类物质的敏感性增加所致。DAMME和其他具有阿片样活性的物质，如吗啡和β-内啡肽，会影响碳水化合物代谢和胰岛素分泌。因此，对脑啡肽等内源性阿片类物质的敏感性增加可能会导致与C.P.A.F.相关的非胰岛素依赖型糖尿病。
