The use of oral hypoglycaemic agents in the treatment of diabetes mellitus

Since their introduction into clinical practice about 30 years ago, the popularity of oral hypoglycaemic agents has waxed and waned. Their use should not lead to the neglect of other facets of management in non-insulin dependent diabetes mellitus, such as diet and exercise, and the introduction of insulin should not be delayed in subjects who are not achieving an adequate control of blood glucose levels. In spite of concerns about the long-term safety and efficacy of oral hypoglycaemic agents that have been raised by the University Group Diabetes Program Study, oral hypoglycaemic agents have an established place in the management of non-insulin dependent diabetes. This article discusses briefly the mechanisms of action and clinical pharmacology of the oral hypoglycaemic agents in common use in Australia, and emphasizes practical issues that are relevant to their clinical use.