caa a22 4500 469128674 CHVBK 20180323133157.0 cr unu---uuuuu 170328e19920301xx s 000 0 eng 10.1007/BF00572824 doi (NATIONALLICENCE)springer-10.1007/BF00572824 A simple clinical approach to discriminate between "true” and "pseudo” secondary failure to oral hypoglycaemic agents [Elektronische Daten] [L. Scionti, P. Misericordia, A. Santucci, F. Santeusanio, P. Brunetti] To discriminate between true secondary failure (TF) and pseudo-secondary failure (PF) to oral hypoglycaemic agents, we studied 34 non-obese non-insulin-dependent diabetic patients who were being treated with these drugs. Nine were in good control (GC) with oral treatment, while 25 showed apparent SF. During a controlled hospital diet, fasting blood glucose remained persistently high in 15 of these patients (TF), while in the other 10 patients it clearly improved (PF). Fasting plasma glucose (FPG) and HbA1c were higher and body mass index (BMI) was lower in TF patients than in PF patients (P<0.01). C-peptide concentrations differed significantly among the three groups both in the fasting state (TF 0.25±0.02 nmol/l, PF 0.70±0.03 nmol/l, GC 0.74±0.03 nmol/l;P<0.0001) and 6 min after glucagon injection (TF 0.50±0.04 nmol/l, PF 1.02±0.06 nmol/l, GC 1.14±0.07 nmol/l;P<0.0001). C-peptide and plasma insulin curves obtained after a standard mixed meal also showed significant differences (P<0.001). In particular, there was a statistically significant difference between GC and PF versus TF (P<0.05), while there was no statistical difference between PF and GC. We conclude that some patients with apparent SF can improve their metabolic control if they strictly adhere to a correct diet (PF); a single measurement of basal C-peptide concentration or examination of the C-peptide and insulin responses to a meal are useful indicators for distinguishing patients with PF from those with TF to oral hypoglycaemic agents. Lower BMI and higher fasting plasma glucose and HbA1c are additional and simple indicators of TF. Springer-Verlag, 1992 Secondary failure nationallicence Oral hypoglycaemic agents nationallicence C-peptide nationallicence Scionti L. Istituto di Medicina Interna e Scienze Endocrine e Metaboliche, University of Perugia, Italy aut Misericordia P. Istituto di Medicina Interna e Scienze Endocrine e Metaboliche, University of Perugia, Italy aut Santucci A. Cattedra di Statistica Medica e Biometria, Istituto di Semeiotica Medica, University of Perugia, Italy aut Santeusanio F. Istituto di Medicina Interna e Scienze Endocrine e Metaboliche, University of Perugia, Italy aut Brunetti P. Istituto di Medicina Interna e Scienze Endocrine e Metaboliche, University of Perugia, Italy aut Acta Diabetologica Springer-Verlag 29/1(1992-03-01), 20-24 0940-5429 29:1<20 1992 29 592 https://doi.org/10.1007/BF00572824 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00572824 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Scionti L. Istituto di Medicina Interna e Scienze Endocrine e Metaboliche, University of Perugia, Italy aut NATIONALLICENCE 700 1- Misericordia P. Istituto di Medicina Interna e Scienze Endocrine e Metaboliche, University of Perugia, Italy aut NATIONALLICENCE 700 1- Santucci A. Cattedra di Statistica Medica e Biometria, Istituto di Semeiotica Medica, University of Perugia, Italy aut NATIONALLICENCE 700 1- Santeusanio F. Istituto di Medicina Interna e Scienze Endocrine e Metaboliche, University of Perugia, Italy aut NATIONALLICENCE 700 1- Brunetti P. Istituto di Medicina Interna e Scienze Endocrine e Metaboliche, University of Perugia, Italy aut NATIONALLICENCE 773 0- Acta Diabetologica Springer-Verlag 29/1(1992-03-01), 20-24 0940-5429 29:1<20 1992 29 592 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer