Oral antidiabetes drugs are of two kinds: sulphon-amide derivatives (sulphonylureas) and guanidine derivatives (biguanides). They are used by 30% of all diabetics. Unlike insulin they are not essential for life.
Following the observation in 1918 that guanidine had hypoglycaemic effect, guanides were tried in diabetes in 1926, but were abandoned a few years later for fear of hepatic toxicity.
In 1930 it was noted that sulphonamides could cause hypoglycaemia, and in 1942 severe hypoglycaemia was found in patients with typhoid fever during a therapeutic trial of sulphonamide. In the 1950s a similar observation was made during a chemotherapeutic trial in urinary infections. This was followed up and effective drugs soon resulted. The first sulphonylureas were introduced into clinical practice in 1954.
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