Influencing factors in secondary failure of sulfonylurea therapy in patients with type 2 diabetes mellitus
Chen Qingxian
Chen Qingqing
Lin Hongman
Liu Lixia
Xiao Fei
Zheng Yu
Abstract：Objective To explore the correlation between glycolipid metabolism,islet function and secondary failure of sulfo-nylurea drugs in patients with type 2 diabetes mellitus.Methods A total of 329 patients with type 2 diabetes mellitus who received sulfonylurea drug treatment at Hainan West Central Hospital from June 2022 to January 2024 were retrospectively selected as the re-search subjects.Based on whether the patients developed secondary failure of sulfonylurea drugs,they were divided into the effective sulfonylurea treatment group(n=285)and the sulfonylurea secondary failure group(n=44).The general clinical data,glucose me-tabolism indexes(fasting blood glucose,glycated hemoglobin)before the treatment,lipid metabolism indexes(serum leptin,serum adiponectin,low-density lipoprotein),islet function-related indexes(fasting insulin,C-peptide)and insulin resistance-related indexes(insulin resistance index,insulin sensitivity coefficient)were observed and compared between the two groups.Multivariate Logistic regression analysis was used to screen the influencing factors in secondary failure of sulfonylurea drugs in the patients with type 2 di-abetes mellitus.Results The body mass index((25.73±1.15)kg·(m2)-1 vs(24.70±1.06)kg·(m2)-1),the proportion of obese patients((36.4% )vs 1(4.4% ))and the proportion of patients with a family history of diabetes((25.0% vs 8.1% ))in the sulfonylurea second-ary failure group were higher than in the effective sulfonylurea treatment group(t/χ2=5.930,12.853,10.033,all P<0.05).Before the treatment,the fasting blood glucose((12.13±2.02)mmol·L-1 vs(10.06±1.18)mmol·L-1),glycated hemoglobin((10.21±1.18)% vs(8.91±1.13)% ),serum leptin((8.94±1.61)ng·mL-1 vs(8.05±1.15)ng·mL-1),fasting insulin((32.35±3.27)pmol·mL-1 vs(29.36±3.03)pmol·mL-1)and insulin resistance index((5.12±0.46)vs(4.30±1.02))in the sulfonylurea secondary failure group were higher than in the effective sulfonylurea treatment group(t=9.654,7.031,4.492,6.016,5.296,all P<0.05),while the insulin sensitivity co-efficient((-4.46±0.29)vs(-4.13±0.33))and C-peptide((0.48±0.07)nmol·L-1 vs(0.60±0.10)nmol·L-1)in the sulfonylurea secondary failure group were lower than in the effective sulfonylurea treatment group(t=7.139,6.418,all P<0.05).Multivariate Logistic regres-sion analysis found that the higher levels of fasting blood glucose,glycated hemoglobin,fasting insulin and insulin resistance index,and the lower level of insulin sensitivity coefficient before the treatment were all important influencing factors in predicting second-ary failure of sulfonylurea drugs in the patients with type 2 diabetes mellitus(OR=3.674,7.807,1.862,2.775,0.002,all P<0.05).Conclusion The degree of glucose metabolism disorder and islet function impairment in the patients with type 2 diabetes mellitus before the treatment is closely related to secondary failure after taking sulfonylurea drugs.For such patients with type 2 diabetes mel-litus,attention should be paid to the selection scheme and dosage of hypoglycemic drugs to adjust blood glucose in a timely manner.
Keywords：Type 2 diabetes mellitusSulfonylurea drugSecondary failureGlycolipid metabolismIslet function
Publication Date：2025-07-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 723-727 )