Is the use of sulphonylurea derivatives in the treatment of diabetes mellitus dangerous?

Abstract

Grouping 651 diabetic deaths according to their treatment with diet alone, with diet and sulphonylurea tablets, with diet and small or large doses of insulin, we cannot discover any significant difference in the duration of diabetes from onset till death between patients treated by diet alone and those treated by diet and hypoglycaemic tablets. The longer duration of insulin-controlled diabetes is mainly due to the younger age of the patients at onset of the disease. Some other factors which may favour insulin treatment are discussed. Neither overweight nor hypertension explains the disparity in duration of diabetes between patients under diet or tablet therapy and others controlled by insulin. Hypoglycaemia and side effects of sulphonylurea derivatives have been known for a long time and are not included in this study. - A critical review of the UGDP report does not give any justification for condemning tolbutamide therapy as dangerous. As in every really efficient medical treatment, sulphonylurea compounds should be used only when necessary, and then with the appropriate dosage, the necessary circumspection and good common sense. © 1971 Springer-Verlag.