An evaluation was made of postmortem findings in a group of fifty-five diabetic patients who were treated with sulfonylurea compounds, primarily tolbutamide, from twenty-four to 112 months, for a total of over 2,500 patientmonths and an average of 45.7 months per patient. The results were compared in “blind” fashion to the postmortem findings in two control groups: (a) fifty-five patients, closely matched to the former as to sex, age at death, and known duration of diabetes, who had been treated with insulin and had never received oral hypoglycemic agents; and (b) nineteen patients who had been treated exclusively by dietary restriction.
The frequencies of myocardial infarcts, cerebral vascular accidents, diabetic retinopathy and nephropathy, as well as neoplasms, thyroid disease, and ulcers of the stomach and duodenum were not statistically different in the three groups. Peripheral vascular disease (gangrene and/or amputations) occurred more frequently in the insulin-treatedgroup, probably because of the customary use of insulin in patients with these conditions. The findings do not provide evidence that the sulfonylureas influence the pattern ofdiseases or specific complications of diabetes when compared to suitable controls.
Islet cell tumors occurred more frequently in sulfonylurea treated patients when compared to the over-all experience of this hospital. The importance of such a finding has to be further substantiated.