The Proper Choice of Oral Antihyperglycemic Therapy in Diabetes Mellitus

Abstract

Insulin therapy can be completely replaced by oral antihyperglycemic therapy in most cases of ketoacidosis-resistant diabetes, i.e., those in which total deprivation of exogenous insulin does not, by itself, precipitate ketoacidosis. In the other major type of diabetes mellitus, termed ketoacidosisprone, deprivation of exogenous insulin will, by itself, precipitate ketoacidosis, and total replacement of insulin therapy is not possible with the agents available at present; the oral agents have been used in these cases as adjuvants to insulin therapy, but in the authors' experience, they have been disappointing.