J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website http://www.jofem.org

Original Article

Volume 5, Number 6, December 2015, pages 321-327

Observational Study of Patients in Morocco With Uncontrolled Type 2 Diabetes Treated With Metformin and/or Sulfonylurea With or Without Insulin

**Table 1.** Socio-Demographic and Clinical Characteristics of the Study Population by Diabetes Treatment at Inclusion
Characteristics	Met and/or Sulf (n = 910)	Met and/or Sulf + insulin (n = 467)	P*
Continuous data are presented as mean (± SD) and categorical data are shown as n (%). BMI: body mass index; FBG: fasting blood glucose; Met: metformin; Sulf: sulfonylurea. *P values were calculated using the Chi-square test for categorical variables and Student’s t-test for continuous variables. †Previous cardiovascular disease comprises angina, myocardial infarction, heart failure, stroke and peripheral vascular disease. ‡Microvascular disease comprises retinopathy, neuropathy or nephropathy.
Male, n (%)	413 (45.7)	175 (37.9)	0.006
Age at inclusion (years)	56.0 ± 9.9	57.9 ± 10.1	0.001
Diabetes duration (years)	6.8 ± 5.3	10.2 ± 5.6	< 0.001
Weight (kg)	77.7 ± 12.2	76.8 ± 12.3	0.201
Waist measurement (cm)	98.5 ± 13.5	96.5 ± 15.2	0.024
BMI (kg/m²)	28.3 ± 4.4	28.4 ± 5.3	0.677
Blood pressure (mm Hg)
Systolic	141.2 ± 20.4	147.0 ± 22.9	< 0.001
Diastolic	82.0 ± 11.9	83.8 ± 11.6	0.007
Clinical history
Previous cardiovascular disease†	52 (5.8)	69 (15.2)	< 0.001
Microvascular disease‡	218 (24.2)	210 (46.1)	< 0.001
Laboratory data
HbA1c (%)	9.3±1.7	10.3±1.9	< 0.001
FBG (mg/dL)	233.9 ± 71.0	269.8 ± 80.8	< 0.001

Table 1. Socio-Demographic and Clinical Characteristics of the Study Population by Diabetes Treatment at Inclusion

Characteristics

Met and/or Sulf (n = 910)

Met and/or Sulf + insulin (n = 467)

Continuous data are presented as mean (± SD) and categorical data are shown as n (%). BMI: body mass index; FBG: fasting blood glucose; Met: metformin; Sulf: sulfonylurea. *P values were calculated using the Chi-square test for categorical variables and Student’s t-test for continuous variables. †Previous cardiovascular disease comprises angina, myocardial infarction, heart failure, stroke and peripheral vascular disease. ‡Microvascular disease comprises retinopathy, neuropathy or nephropathy.

Male, n (%)

413 (45.7)

175 (37.9)

0.006

Age at inclusion (years)

56.0 ± 9.9

57.9 ± 10.1

0.001

Diabetes duration (years)

6.8 ± 5.3

10.2 ± 5.6

< 0.001

Weight (kg)

77.7 ± 12.2

76.8 ± 12.3

0.201

Waist measurement (cm)

98.5 ± 13.5

96.5 ± 15.2

0.024

BMI (kg/m²)

28.3 ± 4.4

28.4 ± 5.3

0.677

Blood pressure (mm Hg)

Systolic

141.2 ± 20.4

147.0 ± 22.9

< 0.001

Diastolic

82.0 ± 11.9

83.8 ± 11.6

0.007

Clinical history

Previous cardiovascular disease†

52 (5.8)

69 (15.2)

< 0.001

Microvascular disease‡

218 (24.2)

210 (46.1)

< 0.001

Laboratory data

HbA1c (%)

9.3±1.7

10.3±1.9

< 0.001

FBG (mg/dL)

233.9 ± 71.0

269.8 ± 80.8

< 0.001

**Table 2.** Treatment Progression Related to HbA1c in Patients With Type 2 Diabetes Mellitus#
Treatment	Baseline	Week-12	Week-26
HbA1c is expressed as the mean (± SD) while HbA1c < 7% is expressed as n (%). #Data are presented for 1,344 patients with HbA1c values available at baseline (33 patients had no baseline HbA1c value). *With or without metformin and sulfonylurea. †P < 0.001 from paired samples in t-test compared between final visit and baseline. ‡P < 0.001 from Chi-square test.
Metformin	80 (6.0)	8.8 ± 1.6	61 (4.6)	7.4 ± 1.0	17 (27.9)	49 (3.8)	6.9 ± 0.9	27 (55.1)
Sulfonylurea	94 (7.0)	9.1 ± 2.0	60 (4.6)	7.6 ± 1.3	19 (31.7)	54 (4.2)	6.9 ± 0.8	34 (63.0)
Metformin and sulfonylurea	710 (52.8)	9.4 ± 1.6	528 (40.1)	8.1 ± 1.4	76 (14.4)	443 (34.3)	7.2 ± 0.8	170 (38.4)
Insulin*	460 (34.2)	10.3 ± 1.9	667 (50.7)	8.8 ± 1.5	30 (4.5)	746 (57.7)	7.7 ± 1.3	188 (25.2)
Total	1,344 (100)	9.7 ± 1.8	1,316 (100)	8.4 ± 1.5	142 (10.8)	1,292 (100)	7.5 ± 1.2†	419 (32.4)‡

Table 2. Treatment Progression Related to HbA1c in Patients With Type 2 Diabetes Mellitus#

Treatment

Baseline

Week-12

Week-26

n (%)

HbA1c

n (%)

HbA1c

HbA1c < 7%

n (%)

HbA1c

HbA1c < 7%

HbA1c is expressed as the mean (± SD) while HbA1c < 7% is expressed as n (%). #Data are presented for 1,344 patients with HbA1c values available at baseline (33 patients had no baseline HbA1c value). *With or without metformin and sulfonylurea. †P < 0.001 from paired samples in t-test compared between final visit and baseline. ‡P < 0.001 from Chi-square test.

Metformin

80 (6.0)

8.8 ± 1.6

61 (4.6)

7.4 ± 1.0

17 (27.9)

49 (3.8)

6.9 ± 0.9

27 (55.1)

Sulfonylurea

94 (7.0)

9.1 ± 2.0

60 (4.6)

7.6 ± 1.3

19 (31.7)

54 (4.2)

6.9 ± 0.8

34 (63.0)

Metformin and sulfonylurea

710 (52.8)

9.4 ± 1.6

528 (40.1)

8.1 ± 1.4

76 (14.4)

443 (34.3)

7.2 ± 0.8

170 (38.4)

Insulin*

460 (34.2)

10.3 ± 1.9

667 (50.7)

8.8 ± 1.5

30 (4.5)

746 (57.7)

7.7 ± 1.3

188 (25.2)

Total

1,344 (100)

9.7 ± 1.8

1,316 (100)

8.4 ± 1.5

142 (10.8)

1,292 (100)

7.5 ± 1.2†

419 (32.4)‡

**Table 3.** Treatment Progression in the Three Groups of T2DM Patients
Characteristics	Metformin and/or sulfonylurea at baseline	Insulin* at baseline (n = 466)
Data are expressed as mean (± SD). FBG: fasting blood glucose. *With or without metformin and sulfonylurea. †P < 0.001, §P < 0.01 and ‡P = 0.01 from a paired-sample t-test.
HbA1c (%)	8.9 (1.5)	7.1 (0.8)†	9.9 (1.7)	7.8 (1.2)†	10.3 (1.9)	7.6 (1.2)†
FBG (mg/dL)	222.6 (66.5)	133.0 (32.1)†	252.1 (70.8)	159.7 (48.3)†	268.4 (79.2)	144.5 (44.3)†
Dose of metformin (mg)	1,367 ± 728	1,552 ± 765†	1,645 ± 735	1,774 ± 706†	1,669 ± 706	1,708 ± 710‡
Dose of sulfonylurea (mg)	10 ± 23	11 ± 24	14 ± 27	15 ± 29	14 ± 28	13 ± 26
Dose of insulin glargine (IU)	-	-	-	15 ± 5	14 ± 6	19 ± 7†
Weight (kg)	78.1 (11.9)	75.6 (10.8)†	77.6 (12.6)	75.6 (11.3)†	77.5 (12.3)	76.5 (11.5)§
Waist circumference (cm)	98.6 (13.1)	95.7 (12.9)†	98.7 (14.6)	95.9 (16.0)†	96.2 (15.4)	95.6 (18.0)
Blood pressure (mm Hg)
Systolic	140.0 (19.8)	132.3 (14.3)†	143.3 (21.7)	134.8 (14.1)†	147.6 (23.1)	134.1 (13.2)†
Diastolic	81.6 (12.1)	78.0 (9.2)†	82.5 (12.0)	79.0 (8.2)†	84.1 (11.7)	77.7 (8.4)†

Table 3. Treatment Progression in the Three Groups of T2DM Patients

Characteristics

Metformin and/or sulfonylurea at baseline

Insulin* at baseline (n = 466)

Maintained on Met and/or Sulf (n = 576)

Progressed to insulin* (n = 330)

Baseline

Week 26

Baseline

Week 26

Baseline

Week 26

Data are expressed as mean (± SD). FBG: fasting blood glucose. *With or without metformin and sulfonylurea. †P < 0.001, §P < 0.01 and ‡P = 0.01 from a paired-sample t-test.

HbA1c (%)

8.9 (1.5)

7.1 (0.8)†

9.9 (1.7)

7.8 (1.2)†

10.3 (1.9)

7.6 (1.2)†

FBG (mg/dL)

222.6 (66.5)

133.0 (32.1)†

252.1 (70.8)

159.7 (48.3)†

268.4 (79.2)

144.5 (44.3)†

Dose of metformin (mg)

1,367 ± 728

1,552 ± 765†

1,645 ± 735

1,774 ± 706†

1,669 ± 706

1,708 ± 710‡

Dose of sulfonylurea (mg)

10 ± 23

11 ± 24

14 ± 27

15 ± 29

14 ± 28

13 ± 26

Dose of insulin glargine (IU)

15 ± 5

14 ± 6

19 ± 7†

Weight (kg)

78.1 (11.9)

75.6 (10.8)†

77.6 (12.6)

75.6 (11.3)†

77.5 (12.3)

76.5 (11.5)§

Waist circumference (cm)

98.6 (13.1)

95.7 (12.9)†

98.7 (14.6)

95.9 (16.0)†

96.2 (15.4)

95.6 (18.0)

Blood pressure (mm Hg)

Systolic

140.0 (19.8)

132.3 (14.3)†

143.3 (21.7)

134.8 (14.1)†

147.6 (23.1)

134.1 (13.2)†

Diastolic

81.6 (12.1)

78.0 (9.2)†

82.5 (12.0)

79.0 (8.2)†

84.1 (11.7)

77.7 (8.4)†

**Table 4.** Association Between HbA1c Levels at 26 Weeks and Patient Characteristics
	HbA1c	P
Data are number.
Sex (F/M)	227/192	504/363	0.180
Obesity (yes/no)	117/297	292/557	0.029
Diabetes familial history (yes/no)	229/186	518/346	0.105
Hypertension (yes/no)	197/206	468/374	0.027
Dyslipidemia (yes/no)	167/213	430/349	0.000
Smoking (yes/no)	75/321	160/649	0.730
Self-monitoring glycemia (yes/no)	144/270	273/571	0.388
OAD (1 vs. 2)	112/294	175/652	0.012
Insulin therapy (yes/no)	116/269	289/493	0.021

Table 4. Association Between HbA1c Levels at 26 Weeks and Patient Characteristics

HbA1c

< 7%

≥ 7%

Data are number.

Sex (F/M)

227/192

504/363

0.180

Obesity (yes/no)

117/297

292/557

0.029

Diabetes familial history (yes/no)

229/186

518/346

0.105

Hypertension (yes/no)

197/206

468/374

0.027

Dyslipidemia (yes/no)

167/213

430/349

0.000

Smoking (yes/no)

75/321

160/649

0.730

Self-monitoring glycemia (yes/no)

144/270

273/571

0.388

OAD (1 vs. 2)

112/294

175/652

0.012

Insulin therapy (yes/no)

116/269

289/493

0.021