The effects of piretanide in patients with congestive heart failure and diabetes mellitus: a double-blind comparison with furosemide

A double-blind parallel group study was carried out to compare the effects of piretanide on daily glucose profiles, symptoms of congestive heart failure and serum electrolytes with those of furosemide in 24 diabetic in-patients suffering from congestive heart failure. After a 3-day run-in period on placebo, patients were allocated at random to receive 10-days' treatment with either 6 mg piretanide or 40 mg furosemide once daily. The results showed that there were no differences between the glucose profiles between the first and the last day of treatment, nor were there any differences between the two treatments. Piretanide and furosemide both produced a significant reduction in the number of symptoms of congestive heart failure. There were no significant changes in biochemical variables within the groups, nor were there any differences between the groups, except for an increase in uric acid and decrease in total protein values after furosemide. Mean triglyceride values decreased significantly after piretanide treatment, and SGOT values decreased after both treatments, the latter change being of no clinical relevance. Side-effects were generally mild in both groups and did not require any counter-measures.