THE TREATMENT OF DIABETES MELLITUS WITH ORAL TOLBUTAMIDE

Abstract

Experience in the treatment of 76 diabetic patients with tolbutamide is described. In 25 patients the drug was discontinued after trials of from 1 week to several months because of poor diabetic control. These treatment failures could be divided into: Group A, completely unresponsive to tolbutamide; Group B, showing hypoglycemic response in the presence of exogenous insulin only; and Group C, responsive in the absence of added insulin, but response inadequate for proper diabetic control.Fifty-one patients who would otherwise have needed insulin were considered adequately controlled on diet and tolbutamide, 1.0 to 3.0 g. daily. No toxic effects were observed. Patients who responded to the drug had a higher mean age, a shorter duration of diabetes, and a lower mean insulin dose. Many exceptions to these individual criteria occurred.It is the author's opinion that oral tolbutamide is established as an adequate replacement for insulin injections in a large proportion of diabetics in the older age group.