INSULIN SECRETION AND IMMUNO‐GENETIC MARKERS IN DIABETICS WITH SECONDARY FAILURE‘ OF ORAL HYPOGLYCEMIC AGENTS

Abstract

‘Secondary failure’ of oral hypoglycemics, in non‐insulin dependent diabetics, has been attributed to dietary non‐compliance, inadequate drug dosage, metabolic stress, or true drug failure. Progressive loss of beta cell function is a suggested mechanism for true drug failure but on the basis of little documented evidence. In view of this, we have measured basal and glucagon‐stimulated C‐peptide levels, human leukocyte antigen (HLA) types, and islet cell antibodies in 20 non‐insulin dependent diabetics with ‘secondary failure’ of oral agents. There were 16 females and four males with a mean ideal body weight of 1.30 units and mean duration of diabetes of 9.5 years. Fasting insulin (mean ± SD:..