To the Editor. — During the past years we have seen two patients with advanced type II diabetes mellitus (non— insulin-dependent diabetes mellitus), macroangiopathy and microangiopathy, and intermittent claudication. They responded poorly to treatment with sulfonylureas and were given insulin. Their metabolic balance remained inadequate. Because of intermittent claudication, they were given 400 mg of pentoxifylline (Trental) orally three times a day. Without changing the insulin dose, adequate balance was obtained in carbohydrate metabolism as seen in blood and urine glucose levels and glycosylated hemoglobin A1c levels. After 2 months of treatment, there was also improvement in walking distance. One of the patients continued to receive the "second-generation" sulfonylurea preparation, glyburide (DiaBeta), throughout this course of treatment. It is assumed that the mechanism of action of sulfonylureas is based on (1) increased insulin secretion by the beta cells of the pancreas, (2) suppression of glucagon and hepatic glucose production,
AMBRUS JL, STADLER S, BANNERMAN R. Effect of Pentoxifylline on Carbohydrate Metabolism in Type II Diabetics. Arch Intern Med. 1990;150(4):921. doi:10.1001/archinte.1990.00390160161056
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