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More than 6 years have elapsed since the introduction of oral hypoglycemic agents for clinical trial. Available on the market in the United States today are 2 sulfonylurea compounds, tolbutamide (Orinase) and chlorpropamide (Diabinese), and a biguanide, phenformin (DBI). Since these drugs are now used by hundreds of thousands of diabetic patients in this country, a critical evaluation of their status is in order.
There is now quite general agreement that the sulfonylureas act by stimulating the release of insulin from the pancreas. This insulin appears to produce its major effect in the liver by promoting a decrease in the output of glucose from that organ into the blood stream. Insulin not so "trapped" in the liver is available for action in the periphery to facilitate the utilization of glucose by tissues, notably muscle and fat. However, such peripheral effects are difficult to demonstrate by the usual methods, presumably because
ORAL HYPOGLYCEMIC AGENTS IN DIABETES. JAMA. 1962;181(1):43–44. doi:10.1001/jama.1962.03050270045012
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