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To the Editor:—
The article on tolbutamide (Orinase) that appeared in The Journal under New and Nonofficial Drugs (164:1333 [July 20] 1957) was very informative. The indications and contraindications were well presented, but one important point, namely, allergy to insulin in diabetics, was not mentioned. Diabetics who find it difficult or impossible to use insulin due to severe local and general manifestations (about 14% of all diabetics, according to Urbach and Gottlieb: Allergy, ed. 2, New York, Grune & Stratton, Inc., 1946, pp. 344-346) are often referred to allergists. This allergy generally affects patients in the middle-aged or older group, the age group most suitably treated with tolbutamide. Therefore, where allergy to insulin is persistent, this drug may be of extreme value.
Engelsher DL. ALLERGY TO INSULIN. JAMA. 1957;165(3):278. doi:10.1001/jama.1957.02980210074021