Use of oral agents in treating diabetes mellitus a perspective

A comprehensive study by the University Group Diabetes Program compared the effects of therapy with oral antidiabetic agents, insulin, and placebo in patients with adult-onset diabetes mellitus. Results showed an increased number of deaths, particularly due to cardiovascular diseases, among patients receiving oral agents. In spite of these findings, therapeutic recommendations have changed only slightly. An FDA proposal recommends moderate labeling changes. When possible, control of diabetes with diet alone should be attempted. If this is unsuccessful, an oral sulfonylurea should be added to the regimen. If glucose and lipid levels remain high after six months of such therapy, insulin should be used.