Analysis of secondary failure to sulfonylureas in type 2 diabetics. A retrospective study for 1976-1987

Secondary failure to sulfonylureas was analyzed retrospectively in order to establish its dependence upon: age of patient at the onset of diabetes, duration of disease, sex, body mass, smoking and diabetic familial anamnesis. A series of 220 cases of type 2 diabetes lasting 1-25 years (mean 8.75 +/- 4.9 years) constituted the subject of study. The age of patients ranged from 31 to 77 years (mean: 63.3 +/- 9.9 years). The mean period of effective management with sulfonylureas equalled 8.75 +/- 4.9 years and was slightly longer in men (9.2 +/- 5.2 years) than in women (8.3 +/- 4.6 years). The age at onset of diabetes and the duration of effective treatment were found to be inversely proportional. The treatment of patients who developed diabetes before the 50th year of age was effective longer (X 10.1 +/- 5.3 years) than that of those with later onset of disease (X 7.9 +/- 4.5 years). This difference was statistically significant (P less than 0.001). In addition, the period of drug effectiveness was significantly longer in obese men (10.1 +/- 5.5 years) than in obese women (8.8 +/- 4.2 years, P less than 0.05). No correlation was found between secondary failure to sulfonylureas on the one hand and smoking and familial occurrence of diabetes on the other.