Vascular complications and long-term administration of oral hypoglycemic agents in patients with diabetes mellitus.
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概要
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To investigate the effect of long-term administration of oral hypoglycemic agents upon the development of vascular complications, a retrospective follow-up study was carried out on 214 diabetic patients for a period of 8 years. These patients were divided into three groups: 38 patients treated with diet alone (group I), 125 patients with sulfonylurea (group II) and 51 patients with insulin (group III). The mean fasting blood glucose levels were generally well controlled through the period of observation in each group. Blood pressure had been treated, but hypertension was observed in 2 to 10% of each diabetic group at the eighth year. Hypoglycemia, albuminuria and ketonuria occurred more frequently in group III than in the other groups. There had been no remarkable changes in serum lipids of these three diabetic groups through the observation period. The percentages of the patients with diabetic retinopathy increased during the follow-up period and significant differences were noted among the three groups at the eighth year (p<0.025). In contrast, no significant difference was demonstrated in the percentage of the ischemic heart disease among these groups. When correlation coefficients between variables in each group were calculated, it was difficult to find out any definite relationship between certain variables. The stepwise multiple-regression analyses suggested that the development of retinopathy or of abnormal ECG was affected by various factors. In addition, statistical analyses were performed on 152 deaths among 2100 diabetics who attended our Clinic between January 1, 1961 and August 31, 1976. The mortalities were 8.9% for the group with diet alone, 3.5% for the group with sulfonylureas and 11.9% for the group with insulin, and these values were different with a statistical significance (p<0.001). As a whole, 32 patients (21.7%) died of malignant neoplasma, 25 (16.4%) of renal diseases and 24 (15.8%) of cerebral vascular accidents. Fatal myocardial infarction and cardiac insufficiency were detected in 6 (3.9%) and 5 (3.3%) patients, respectively. The percentages of deaths from heart disease were low and no significant difference was observed in the mortality of cardiac events between the three groups. The results obtained in the investigation did not support the UGDP study.
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東北ジャーナル刊行会 | 論文
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