The How, When and Where of the Oral Hypoglycemic Compounds

Abstract

Juvenile-type diabetes is a contraindication to use of any oral hypoglycemic compound as the sole therapeutic agent. The best candidates for this therapy alone, without insulin, are diabetics whose disease appeared after the age of 40 years, is of less than 10 years' duration, and is stable, requiring small doses of insulin. Phenformin seems to enhance glucose utilization and to augment the action of endogenous or exogenous insulin; its use in obese diabetics has been recommended. In general, insulin-sulfonylurea combination therapy has not been effective. Phenformin-insulin therapy occasionally may be beneficial. A combination of sulfonylurea and phenformin also may be advantageous. Initial “loading doses” are no longer used.