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tolbutamide tablets are indicated as an adjunct to diet to lower the blood glucose in patients with non insulin dependent diabetes mellitus type ii whose hyperglycemia cannot be controlled by diet alone in initiating treatment for non insulin dependent diabetes diet should be emphasized as the primary form of treatment caloric restriction and weight loss are essential in the obese diabetic patient proper dietary management alone may be effective in controlling the blood glucose and symptoms of hyperglycemia the importance of regular physical activity should also be stressed and cardiovascular risk factors should be identified and corrective measures taken where possible if this treatment program fails to reduce symptoms and or blood glucose the use of an oral sulfonylurea or insulin should be considered use of tolbutamide tablets must be viewed by both the physician and patient as a treatment in addition to diet and not as a substitute for diet or as a convenient mechanism for avoiding dietary restraint furthermore loss of blood glucose control on diet alone may be transient thus requiring only short term administration of tolbutamide tablets during maintenance programs tolbutamide tablets should be discontinued if satisfactory lowering of blood glucose is no longer achieved judgments should be based on regular clinical and laboratory evaluations in considering the use of tolbutamide tablets in asymptomatic patients it should be recognized that controlling the blood glucose in non insulin dependent diabetes has not been definitely established to be effective in preventing the long term cardiovascular or neural complications of diabetes
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