Abstract

Background: Secondary oral hypoglycaemic agent (OHA) failure is one of the many challenges of diabetes management, the consequence of which is poor diabetes control and early development of chronic complications. Prospective studies on secondary OHA failure have not been done in Nigeria. The aim of this study was to determine the prevalence and risk factors associated with development of secondary failure of OHA among T2DM subjects. Methods: A cross sectional study of 200 hundred consecutive T2DM patients was studied over a 12 months period. Parameters studied included age, sex, BMI, WC, c-peptide, glucose and lipids profiles and GADA. The prevalence of OHA failure was determined using simple percentage and risk factors were determined by comparing the clinical and laboratory parameters between subjects with and without OHA failure. The relative risk and predictors of OHA failure were estimated by calculating the odds ratio (O.R) and logistic regression. Results: The mean (SD) age of the subjects was 52.5(9.7) years. The prevalence rate of secondary OHA failure was 36% (72/200) with a female preponderance 46(63.9%); males were 26(36.1%), P > 0.05. The means (SD) of BMI 22.9(5.4) kg/m2, WC 87.7(11.3) cm and c-peptide 0.84(0.05) were lower in subjects with OHA failure than those without OHA failure. P < 0.05. The mean (SD) 2 hr PPG [14.5(3.7) mmol/L] and HbAlc [8.3(1.42)%] of those with OHA failure were higher than in those without OHA failure. p < 0.05. The mean (SD) TC, LDL-C and TG in subjects with OHA failure were lower than in subjects without OHA failure, p > 0.05. The prevalence of anti-GAD positivity in those with OHA failure was 30.5%. Conclusion: It is concluded, in this study, that the prevalence of secondary OHA failure among T2DM patients was found to be 36%. It appeared commoner in females and associated with lean subjects, longer duration of diabetes with β-cell dysfunction and GAD positive.

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