The cornerstone of all proper treatment of diabetes mellitus is a diet adjusted to the patient's weight, height, sex, physical activity, and diabetic status. Regular insulin is essential in treating acidosis and coma; the lente insulins and other derived insulins can be used advantageously in combination with it. he group of sulfonylureas which includes carbutamide and tolbutamide must still be used with caution but are known to give the best results in the nonketotic, asymptomatic diabetic whose weight is normal, age over 40 years, and insulin requirement less than 40 units per day. The group of biguanides is represented by phenformin (DBI, phenethylbiguanide), which has replaced as much as 70 units of insulin daily in one patient and promises to play a role not hitherto filled by diet, insulin, or sulfonylureas.
Perkin FS. PRACTICAL USE OF HYPOGLYCEMIC AGENTS. JAMA. 1960;173(1):36–37. doi:10.1001/jama.1960.03020190038008