Long‐term monitoring during clofibrate therapy

Clofibrate, 2.0 Gm. per day, was taken by 22 patients with diabetes mellitus for 2 to 5 years. Bromsulphalein retention of unknown origin developed in one patient and muscle pain unrelated to the drug appeared in another. Mean serum total cholesterol and triglycerides and their alpha and beta lipoprotein fractions, within the nonelevated range prior to therapy, remained at or below this range during treatment. Most of the other clinical and laboratory indices remained unchanged during the second, third, fourth, and fifth years of therapy. These included body weight, blood pressure, pulse rate, and serum sodium, potassium, total protein, albumin, calcium, inorganic phosphorus, creatinine, malic acid dehydrogenase, creatine phosphokinase, alkaline and acid phosphatase, serum glutamic pyruvic transaminase, and total bilirubin. Also, the hemoglobin, hematocrit, the erythrocyte and platelet count in peripheral blood, and the prothrombin time did not change. Nonsustained changes, i.e., present in one or 2 of the 2 to 5 years of treatment, were observed in a minority of the indices. These comprised serum non esterified fatty acids, carbon dioxide, chloride, globulin, lactic acid dehydrogenase, ado lase, serum glutamic oxalacetic transaminase, and thymol turbidity, urine creatinine and pressor activity, and bleeding and coagulation time. Increases in the serum uric acid in the group with adult‐onset diabetes and in the serum creatine in those with iuvenile type of diabetes were more persistent and could well be concomitants of aging and maturation. The lesser hyperglycemia observed during oral glucose tolerance tests in the juvenile group may also represent the amelioration of the diabetes as a part of the natural course of the disorder