Therapy of early diabetes. The University Group Diabetes Program.

Publisher Summary This chapter focuses on the therapy of early diabetes under the University Group Diabetes Program (UGDP). Early detection and treatment of patients with adult-onset diabetes is often undertaken because of the conviction that any measure that lowers blood glucose to or toward normal will prevent or postpone the appearance and progression of vascular complications. The chapter describes a study in which 1027 patients were randomized. The mean age was 52.7 years and approximately 60% of all patients were between the ages of 45 and 64. The mean 2 h blood glucose after a standard challenge was 229 mg%. The mean body weight was a third above normal, and a slight majority of these patients was female. Higher mortality was observed for all causes and for cardiovascular causes in patients treated with both tolbutamide and phenformin when compared to the other treatment groups. Patients without evidence of ECG abnormality, without evidence of angina, without a history of digitalis, with cholesterols below 300 mg%, and less than 55 years of age had a mortality experience in the tolbutamide-treated group that was greater than all other subgroups in other forms of therapy.