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The Tolbutamide Controversy: A Personal Perspective

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▸Requests for reprints should be addressed to Theodore B. Schwartz, M.D., 1753 West Congress Pkwy., Chicago, Ill. 60612

Chicago, Illinois

Ann Intern Med. 1971;75(2):303-306. doi:10.7326/0003-4819-75-2-303
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It is only with some difficulty that even the older clinician can recall the days before the advent of tolbutamide for the treatment of maturity-onset diabetes. This is because tolbutamide, other sulfonylureas, and the biguanides have entrenched themselves as highly satisfactory therapeutic agents. Until 13 years ago the treatment of the adult-onset, obese diabetic often evolved into a battle between a concerned physician, who sternly offered the alternatives of prodigious weight loss and daily insulin injections, and a reluctant patient whose mood ranged from anxiety and hostility through desperation and despair. Despite early cautionary voices, the oral hypoglycemic agents were




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