Clinical Investigation of Treatment Failure in Type 2 Diabetic Patients Treated with Metformin and Glibenclamide at a Hospital in Northwestern Nigeria

Purpose: To examine body mass index (BMI), occupation, sex, age, and duration of therapy as contributory factors in treatment failure in type 2 diabetic patients taking metformin and glibenclamide in a tertiary hospital in Northwestern Nigeria.
Method: A retrospective case control study was employed where variables (age, sex, body mass index, tribe, duration of therapy, glycaemic profile and occupation) for a total of 520 type 2 diabetic patients that took metformin and glibenclamide for a minimum of 1 year were examined. Patients were classified into two groups based on progression to triple oral therapy or a switch from metformin and glibenclamide therapy.
Results: Of the 520 patients analysed, 276 failed treatment. Over 90 % of the patients were > 40 years while 61 % had been on treatment for > 4 years. The subjects’ mean age was 53.22 ± 9.03 years. The mean population body mass index (BMI) was 27 kg/m². Housewives comprised more than half of the population (55.5 %). The mean fasting blood glucose and 2 h post prandial blood glucose levels of group 1 were 5.99 ± 0.67 mmol/L and 8.76 ± 2.19 mmol/L respectively while the corresponding values for group 2 were 12.55 ± 4.12 mmol/L and 18.42 ± 5.3 mmol/L, respectively.
Conclusion: Progressive deterioration in pancreatic ß-cell function, BMI > 28 kg/m², advancing age, and young age at diagnosis were identified as contributory factors to the development of secondary failure in type 2 diabetics receiving metformin and glibenclamide.

Keywords
Diabetes; Glibenclamide; Metformin; Pancreatic ß-cell function; Treatment failure