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May 23, 1980

Hypoglycemic Treatment: Guidelines for the Non—insulin-dependent Diabetic

JAMA. 1980;243(20):2078-2079. doi:10.1001/jama.1980.03300460052032

THE CONTINUING controversy during the last ten years surrounding the findings of the University Group Diabetes Program (UGDP) has resulted in a morass of analyses, reevaluations, rebuttals, statistical logistics, and confusion on the part of interested observers. The latter unfortunately includes physicians who must make therapeutic decisions concerning management of non-insulindependent (non-ketosis-prone or maturity-onset type) diabetic patients and, particularly, the appropriate use of oral antidiabetic agents (ie, sulfonylureas in the United States) in these persons.

The UGDP study was designed to evaluate the effectiveness of hypoglycemic treatments in prevention or mitigation of the chronic vascular complications in non-ketosis-prone diabetes. Conclusions of the study included the following: (1) the combination of diet and tolbutamide therapy was no more effective than diet alone in prolonging life; (2) the incidence of cardiovascular deaths was higher in the tolbutamide-plus-diet group than in the groups treated with diet alone or diet plus insulin. Overall death