[Insulin secretion and sensitivity in patients with secondary failure to oral hypoglycemic drugs].
Secretion and peripheral sensitivity to insulin was investigated in diabetic patients with secondary failure to oral hypoglycemic drugs. 8 patients with secondary failure (non responders), 7 non insulin dependent diabetic patients with good response to oral drugs (responders) and 8 control subjects were studied. Insulin secretion was determined with peptide C in urine obtained 4h after a 500 Cal breakfast; in vivo insulin sensitivity was studied by the euglycemic hyperinsulinemic clamp technique. All groups were comparable in age, nutritional status and duration of diabetes. Non responders had higher fasting blood sugar levels compared to responders (228 +/- 70 vs 136 +/- 21 mg/dl, p < 0.05). Controls had lower blood sugar levels than the other 2 groups (93 +/- 8, p < 0.05). Insulin levels were similar in non responders and responders (24 +/- 12 and 16 +/- 9 uU/ml, respectively) and higher than in controls (10 +/- 3, p < 0.05). Peptide C was lower in non responders than in responders (3.8 +/- 1 vs 5.3 +/- 1.4 nm/4h, respectively, p < 0.04), but similar to controls (4.4 +/- 1.2). No difference in secretion of insulin was noted between non responders and responders. Insulin sensitivity index was 3.67 +/- 1.41 ((mg/kg.min)/(uU/ml)). 100 in non responders and 4.20 +/- 1.14 in responders; the index for controls was 7.92 +/- 1.70 (p < 0.05). These results show that non responders have normal insulin levels, although inappropriate for the level of hyperglycemia. Insulin sensitivity in non responders is similar to responders but lower than controls.(ABSTRACT TRUNCATED AT 250 WORDS)
López
G
G
Unidad de Diabetes y Nutrición, Facultad de Medicina, Universidad de Chile.
Calvillán
M
M
Durruty
P
P
Rocha
G
G
D000284:Administration, Oral; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure
D007004:Hypoglycemic Agents; D007328:Insulin
Secrecion y sensibilidad insulinica en el fracaso secundario a drogas hipoglicemiantes orales.