REPORT ON EXPERIENCES IN ONE AND A HALF YEARS OF ORAL TREATMENT OF DIABETES WITH TOLBUTAMIDE

For the last eighteen months we have been treating diabetes with tolbutamide (Orinase). During that time, 550 patients have been stabilized on tolbutamide in our clinic. Fifty of these patients received combined treatment of insulin plus tolbutamide. I shall not deal with the latter group in detail since observation of these cases did not demonstrate anything that has not already been published.', 2, Four hundred and fifty of our patients (FIGURE 1) are now being treated with tolbutamide. Of these, 410 are more than 50 years old, and most of them are more than 60. In 17 patients, the diabetes mellitus became rhanifest before they were 40 years old. The stabilization on tolbutamide was carried out exclusively in the clinic, on the metabolism ward. One hundred and seventy patients had been previously treated with insulin; 133 patients were poorly controlled by diet alone; and 147 patients were newly detected diabetics who could not be controlled with diet alone. With all the patients of the last two groups, a strict dietetic regimen was tried first. Three carbohydrate-free test days were ordered, followed by a limitation of the carbohydrates to 120 gm. Only if, within 1 to 2 weeks, no fair balance was reached on a diet limited in