[Delayed sulfonylurea resistance in non-insulin-dependent diabetes mellitus]

Non-insulin-dependent diabetes mellitus is one of the most common non-infectious diseases in Hungary. Oral hypoglycaemic agents, especially sulfonylurea drugs are basic therapeutic tools in the treatment of the disease. The cellular effects of sulfonylurea drugs are continuously investigated as their mode of hypoglycaemic action remains controversial despite the large number of experimental trials. According to the immediate or progressive nature of its insufficient blood glucose lowering effect, early (primary) and late (secondary) sulfonylurea failure can be distinguished. There are no exact criteria for the secondary sulfonylurea failure state. Having excluded causes other than drug failure, blood glucose profiles, and, if possible, serum or urinary C-peptide measurements should be carried out. Once sulfonylurea failure has been established other classes of antihyperglycaemic drugs in combination with insulin therapy or insulin therapy alone are to be introduced, respectively.