Metabolic control of type-2 diabetic patients commonly treated with sulphonylureas in a developing country.

BACKGROUND Previous reports suggest that currently available drugs used in the treatment of type 2 diabetes do not sustain glycaemic control. OBJECTIVE To assess metabolic control in type 2 diabetic patients predominantly treated with sulphonylurea drugs at primary care clinics in a developing country. DESIGN Descriptive. SETTING Two primary care clinics in Trinidad, West Indies. SUBJECTS One hundred and seventy nine (117 females and 62 males), randomly selected, type 2 diabetic patients. PROTOCOL Body weight, height, blood pressure (BP), waist and hip circumferences were measured and fasting blood samples taken for glycated haemoglobin (HbA1c, glucose, insulin and lipids determinations. Fasting insulin and glucose concentrations were used to assess insulin resistance and sensitivity (%S) using Homeostasis model assessment (HOMA) method. RESULTS Of the 179 patients studied, 87% of male and 92% of female patients were treated with sulphonylurea drugs whereas 13% and 9% of male and female patients respectively were managed on diet and/or exercise. Female patients had significantly higher prevalence of obesity than males, and despite similar fasting glucose and HbA1c, levels, the females and patients of East Indian ethnic group had significantly higher prevalence rates of insulin resistance, hypercholesterolaemia, hypertriglyceridaemia and reduced HDL-cholesterol than the males and patients of African origin respectively. CONCLUSION Consistent with previous reports, the results showed indications of poor metabolic control among the patients particularly females and patients of East Indian ethnic group.