Weight loss reverses secondary failure of oral hypoglycaemic agents in obese non-insulin-dependent diabetic patients independently of the duration of the disease

A. E. Pontiroli, A. Calderara, M. Pacchioni, C. Cassisa, G. Pozza

Research output: Contribution to journalArticle

Abstract

The aim of the present study was to evaluate whether reduction of body weight is able to restore sensitivity to oral hypoglycaemic agents in obese non-insulin-dependent diabetic patients with secondary failure of to the antidiabetic drugs. 80 obese patients (BMI ~ 30 kg/m2) with Type 2 diabetes lasting 1-30 years and showing hyperglycaemia for at least 3 months (51 on insulin, 29 on oral drugs) received an 800 kcal diet for 20-24 days, lost about 6.3% BMI, and returned to euglycaemia; 22 obese euglycaemic Type 2 diabetic patients (9 on insulin, 13 on oral therapy) underwent the same treatment, and lost approximately 8.3% BMI. As a result insulin could be withdrawn in 18 out of 60 patients and reduced (from 0.5 to 0.2 U.kg day) in the remaining patients. Oral therapy could be withdrawn in 17 out of 42 cases and reduced (from 12.1 to 8.6 mg glibenclamide/day) in the remaining cases. As a control group, 20 non obese (BMI <24.0 kg/m2) hyperglycaemic Type 2 diabetic patients (10 on oral hypoglycaemic agents, 10 on insulin) with Type 2 diabetes lasting 1-26 years, underwent the same dietary regimen, lost about 3.2% of body weight, but could not withdraw insulin, which had to be started in 6 previously oral hypoglycaemic drugs treated patients. Systolic and diastolic blood pressure and serum cholesterol and triglyceride levels also decreased in obese, but not in non-obese Type 2 diabetes patients. These data indicate that: 1) secondary failure is of a different nature in nonobese and obese Type 2 diabetic patients; 2) non insulin dependent diabetes is a progressive disease, eventually leading to insulin requirement in non obese patients, but not in the majority of obese patients; 3) diet retains its therapeutic role in long-lasting Type 2 diabetes; 4) it is likely that, the majority of obese Type 2 diabetes patients are unnecessarily treated with insulin.

Original languageEnglish
Pages (from-to)30-35
Number of pages6
JournalDiabete et Metabolisme
Volume19
Issue number1
Publication statusPublished - 1993

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Keywords

  • diabetes duration
  • oral hypoglycaemic agents
  • weight loss

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

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