The use of hypoglycaemic drugs for the treatment of diabetes mellitus dates from 1955. The two groups of compounds available, the sulphonylureas and the biguanides, have entirely different modes of action in lowering the blood sugar of the diabetic patient. They are used when dietary restriction alone is ineffective in controlling the diabetes and where insulin is not the treatment of choice. They are effective, but an important large trial1 has raised some doubts about their long-term use. The place of these drugs therefore needs to be reassessed.
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