[Aspects of antihyperglycemic oral bitherapy in 76 cases of non insulindependent diabetes in Dakar].

Some reasons justify the introduction of the association of sulfonylurea and metformine when monotherapy is ineffective. Hereafter a period of monotherapy by sulfonylurea or metformine only bitherapy has been instituted. Socio-demography, number of consultations, type of monotherapy and of association, duration of treatment, body mass index, fasting blood glycemia and post-prandial glycemia, blood pressure and type of complication were studied. There were 2.5 times more women than men with lower mean age for women. The majority of patients were from Dakar (81.6%). More than half of patients were women at home (60.5%). Present obesity (plethoric diabetes) or past obesity (metaplethoric diabetes) concerned 90.3% of patients. Patients have done 9.14 4.39 consultations under bitherapy. The gliclazide-metformin association was observed 37 times and the glibenclamide-metformin association 67 times. The duration of monotherapy was 45.9 39.7 months and that of bitherapy 92.5 43.7 months. The variations of body mass index showed a diminution of 1.26 kg/m2 and for fasting blood glycemia and augmentation of 0.011 g/L and post-prandial a diminution of 0.05 g/L. The body mass index variations in diabetic patients showed a diminution of weight more in plethoric patients in bitherapy compared to monotherapy. This study is retrospective and cannot show the optimal efficacy of bitherapy. But the combination of enhancement of glucose captation and lowering of hepatic glucose production has been shown during this bitherapeutic association. Addition of metformine and treatment with sulfonylurea make a combination that significatively improves glycemic control but also cholesterol level and allows obtation of better weight in type 2 non insulin-dependent diabetes with insulinoresistance.