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To the Editor:—
I read with interest the two articles in the Dec. 24 issue of The Journal on combined oral therapy for diabetes. Both of the authors clearly presented and documented their experience and opinions. I believe, however, that one rather important item has been omitted from both articles.I grant that a certain percentage of patients can be controlled on two agents when either one alone is unsuccessful. However, it is generally conceded that this particular type of patient can be controlled with a reasonable amount of depot insulin. Our experience with a similar group of cases supports this idea. I know that the combined oral approach is adaptable for an occasional person with diabetes. However, its potential inconvenience and expense outweighs, in my opinion, most of its advantages. For example, Dr. Unger's patients taking 3 gm. of tolbutamide daily and an average of 159 mg. of phenformin
Whitehouse FW. Oral Therapy in Diabetes. JAMA. 1961;176(3):245. doi:10.1001/jama.1961.03040160065026