Effect of nicotinamide on blood sugar and blood acetone bodies of diabetic and normal subjects.

Gobell (1) showed that 100 mg. of nicotinamide injected intravenously into children produced regularly a fall in the blood sugar level, averaging 21.3 mg. per cent. The hypoglycemic action of nicotinic acid was also observed in normal human adults by Marche and Delbarre (2), PoumeauDelille and Fabiani (3), and Neuwahl (4). In experiments with animals Ledrut (5) observed a marked decrease in the blood sugar level in normal rabbits which received nicotinic acid orally or intravenously. Large doses of nicotinic acid injected into rats produced hypoglycemia in the hands of Cherkes and Rozenfeld (6). Neuwahl reported (4) that an intravenous injection of 250 mg. of nicotinic acid in eight non-diabetic subjects produced a blood sugar level as low as 48 mg. per 100 cc., which led to long lasting rigor. When glucose was injected along with nicotinic acid, no reaction was observed. Horst (7), on the other hand, reported that the administration of nicotinamide to persons with normal metabolism had no influence on the fasting blood sugar level or on the glucose tolerance curve. Neuwahl (4) observed a definite improvement in the carbohydrate tolerance in twelve diabetic patients receiving nicotinic acid. Gordon (8) reported a patient on a diet of 1200 calories who had a fasting blood sugar of 160 mg. per 100 cc. of blood. After the patient was fed 1200 mg. of nicotinamide per day for 1 month, the blood sugar dropped to 60 mg. per 100 cc. of blood. Contrary to the findings of Neuwahl (4) and Gordon @),Poumeau-Delille and Fabiani (3) did not notice any effect of nicotinic acid on the glycemia of diabetic patients. Wade (9) also reported that 666 mg. of nicotinamide fed thrice daily for 14 days to six diabetic patients who were receiving adequate insulin neither influenced the sugar tolerance nor improved the diabetic condition. In view of the conflicting reports cited above and in view of the observation that nicotinic acid prevents the diabetogenic action of alloxan (10) in rabbits and rats, it was thought desirable to study the effect of intravenous injection of nicotinamide on the blood sugar and blood acetone bodies of diabetic and normal subjects.