In 1926, Frank, Nothmann and Wagner1 isolated a guanidine derivative, a diguanidyl decamethylene, which they called "Synthalin." This was reported to be effective in reducing blood sugar when taken by mouth and was suggested as a substitute for insulin in the treatment of diabetes. Numerous publications have appeared, especially in Europe, concerning its use in diabetes and the possible mechanism of its action. A supply of synthalin 2 was obtained for therapeutic trial on diabetic patients. During the course of this investigation, a study was made of the respiratory quotients after a meal of dextrose. It is believed that any drug reputed to have an insulin-like action must manifest itself by an increased oxidation of carbohydrate in the diabetic organism. Blatherwick, Sahyun and Hill3 stated that synthalin may possibly produce a hypoglycemia by an insulin-like action or by interfering with normal glyconeogenesis because of injury to the liver. The present
KARR WG, SCHUMANN C, PETTY OH. THE EFFECT OF SYNTHALIN ON THE RESPIRATORY QUOTIENT OF THE DIABETIC PATIENT. Arch Intern Med (Chic). 1929;43(3):384–392. doi:https://doi.org/10.1001/archinte.1929.00130260087008
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