A long term study carried out on more than 15000 diabetics at a private, one man’s, non-supported, primary level diabetic clinic during 42 years, on uncontrolled diabetics revealed that:

1. Some poorly treated/unwell diabetics may exhibit “Delayed chemical-diabetic control” to endogenous insulin (releasing sulphonylureas or erxogenous insulin injection) inspite of good “Clinical Response” like healing of skin lesions within 3 days.

2. Addition of optimum tolerable dose of biguanides usually hastened Chemical Glycemic control.  Clinical trials study at New York Univ. Hospital and in India of ammoniated carbutamide (1956-59) disclosed that there were no true failures in NIDDS.   As carbutamide was phased out due to sulpha drug type skin reactions and methylated tolbutamide was substituted, its failures responded to chlorinated chorpropamide.

3. Biguanides in large divided after meal doses helped to control glycemia and obesity, but its real value was in actions of reducing insulin resistance in sulphonylurea or insulin treated diabetics.   The minimum dose of metformin was 1.8-3.0gm, 150-300mg of phenformin twice daily.

4.. When metformin hastened the chemical response with chlorpropamide and also induced smooth control and reduced chforpropamide dose.  French investigators Sterne & Aron welcomed this breakthrough (light had to come from Asia…).   Soon Samuel Baser at Harvard Univ, reported similar findings with chlorpropamide phenfrmin combination.  A fixed tolerable after meal divided biguanide dose with variable reducing chlorpropamide dose as per need for smooth lkong-term glycemic control, proved a real boon to NIDDS.

 5.. Almost all (95%+) of patients received at this private clinic were failures to oral /insulin therapy and mot responded to this combination tablets.  Amongst non-responders were true insulin-dependent, non-ketosis pron requiring insulin for well-being, or few with severe metabolic stress due to uncontrolled inflammatory Infective/degenerative processes where WBC and ESR were usually high. In infections like Koch’s responded to anti-TB drugs only, their glycemia was getting controlled with this combination. They could recover without events and they even responded to any drugs they were taking before.  Uncontrollable glycemia during heart attack/stroke type events indicated poor prognosis.

A very detailed chemical structural study will be exhibited though posters with comments.  Also communication/personal discussions with investigators at their research establishments will be revealed with data of useful drugs, which were never put in market.