Is sulphonylurea therapy effective long term? A 3-year study with gliclazide

Fifty non-insulin-dependent diabetic patients, aged 59.06 +/- 1.37 years and overweight (119.3% of ideal body weight), with an impaired daily glycaemic profile despite a carbohydrate restrictive diet were treated with gliclazide (40 to 320 mg per day) for 36 months. Forty-four patients completed the full study (3 drop-outs for secondary failure, 3 others for reasons not related to the treatment). Mean daily plasma glucose levels (fasting, 10.00, 12.00 and 16.00 hours) decreased significantly from 15.2 +/- 0.7 to 6.9 +/- 0.2 mmol/l after 36 months. Mean fasting plasma glucose level decreased significantly from 12.7 +/- 0.5 to 8.2 +/- 0.2 mmol/l after 3 months and continued to decrease to 6.9 +/- 0.3 mmol/l after 36 months (p less than 0.01). Fatty acids, cholesterol, and triglycerides plasma levels also decreased significantly from 0.53 +/- 0.06 mmol/l, 6.3 +/- 0.2 mmol/l and 1.9 +/- 0.2 mmol/l, respectively to 0.32 +/- 0.01 mmol/l, 5.8 +/- 0.1 mmol/l and 1.6 +/- 0.1 mmol/l, respectively. No weight gain was observed: mean body weight decreased significantly from 68.2 +/- 1.7 to 64.0 +/- 1.4 kg, indicating that gliclazide did not interfere with diet-induced weight loss. Importantly, platelet adhesiveness, abnormal before treatment 77.2 +/- 1.3% (normal less than 70%), improved throughout the study to 57.8 +/- 1.3% after 36 months of gliclazide. Treatment was well tolerated and no hypoglycaemic attacks or other side-effects were reported.