ECE2019 Guided Posters Diabetes: Pharmacotherapy (12 abstracts)
13rd Local Primary Care Unit (TOMY), Thessaloniki, Greece; 2Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece; 3Diabetes Center, Department of Internal Medicine, G. Papanikolaou General Hospital, Thessaloniki, Greece; 4Medical Laboratories Analysi Iatriki S.A., Thessaloniki, Greece; 5Medical Laboratories, Alexander Technological Educational Institute, Thessaloniki, Greece; 6Nursing Department, Alexander Technological Educational Institute, Thessaloniki, Greece.
Background: Sulfonylureas (SUs) are known to increase fasting insulin levels in patients with Type 2 Diabetes (T2D) treated with these agents. Whether this increase is related to a greater risk of hypoglycemia has not yet been sufficiently elucidated.
Methods: The study included 58 patients with T2D who had been on treatment with SUs, but not insulin, for more than 2 years. Confirmed hypoglycemic episodes during the past year were self-reported by the patients on a retrospective basis, by completing the Hypoglycemia Patient Questionnaire weighted scoring system. Potential relationship of hypoglycemic event frequency with fasting insulin levels and received therapy was investigated.
Results: Fasting insulin concentrations were found to have a low positive and statistically significant correlation with the number of cases of mild hypoglycemia per year (rho=0.279/P=0.034), and a moderately positive and statistically significant correlation with the number of severe hypoglycemic events per month (rho=0.349/P=0.007) and per year (rho=0.39/P=0.002). Patients on glimepiride had significantly higher number of mild hypoglycemic episodes during the previous month (P<0.001) and the previous year (P<0.001), compared to patients receiving gliclazide. Regarding the relationship between received treatment with SU and fasting plasma insulin levels, no statistically significant difference between gliclazide and glimepiride was observed (P=0.591).
Conclusions: The incidence of hypoglycemia in patients treated with modern SUs seems to vary, depending on the specific medication used. Fasting insulin levels could be a predictor of risk of hypoglycemia in patients with T2D on treatment with SUs.