The role of oral hypoglycemic agents in therapy and prevention of macrovascular complications.

Of all the possible atherosclerotic factors, it must be accepted that only a few can be reached by today's diabetes therapy. Control of diabetes (hopeful, but not proven); Aging--useful but only in as much as good treatment might retard the aging process (questionable); Obesity--a great generality (possibly helpful); Lipids and lipoproteins (probably helpful, although more specifics needed); Hyperinsulinism (questionable--more studies underway); Platelet changes and coagulation (probably an important area--much investigation underway); There is no real evidence that any oral hypoglycemic agent is specific for treatment in these areas. Claims are made for some of the present oral hypoglycemic agents. Are these alleged benefits due to the specific properties of these agents or are they simply reinforcement of good diabetes control? There have been some specifically favorable reports of experiments with glicazide. If these are true, this would add another important dimension to its accepted hypoglycemic role. At this time, the oral hypoglycemic agents must be considered adjuncts in good control of diabetes and as such might provide a beneficial influence on atherosclerosis and macrovascular complications, but this is hardly specific.