Oral Hypoglycaemic Drugs

observations on the potent hypoglycaemic action of a sulphonamide, I-butyl 3-sulphanilyl urea, called carbutamide.t After extensive clinical trials in America, Canada and the United Kingdom carbutamide has been withdrawn from clinical use because of the high incidence of serious toxic effects. About 5 per cent. of 7,193 patientsdeveloped skin rashes, gastro-intestinal disorders, severe leucopenia, liver damage and generalized sulphonamide sensitivity reactions; eight patients died IO to 30 days after starting treatment(Kirtley, 1957). In the past two to three years another sulphony-lurea, tolbutamide, which lacks the p-amino group of the sulphanilamide derivatives, has been widely used without serious ill-effect in the treatment of mild diabetes mellitus of the adult type. How thedrug acts is still uncertain, but its clinical useful-