الفهرس 
diabetes mellitus
biochemical analysisOnly 14 pages are availabe for public view
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Abstract
OBJECTIVE: The aim of this study was to investigate the possibility that genetic factors may predispose to sulfonylurea failure. The genetic factors were represented by the E23K polymorphism in KCNJ11 gene and Arg972 polymorphism in IRS-1 gene. RESEARCH DESIGN AND METHODS: A total of 100 unrelated Egyptian type 2 diabetic patients were recruited. They were divided into two equal groups: group I have patients with secondary failure to sulfonylurea despite oral sulfonylurea + metformin therapy while group II have patients controlled with oral therapy (sulfonylurea + metformin). RESULTS: Of the total patients, (45%) were carriers of K allele, and the remainder (55%) were homozygous for the wild-type allele. The genotype frequency of the E23K Kir6.2 variant was 34% among diabetic patients well controlled with oral therapy and 56% among patients with secondary failure to sulfonylurea (odds ratio 1.65, P= 0.04). Among patients with secondary failure, carriers of the K allele had an earlier age at diagnosis of diabetes (P= 0.03) and showed a tendency toward shorter duration of therapy with oral agents before failure (P =0.000) as compared with E23E homozygous. For Arg972 IRS-1 variant, (14%) were heterozygous and the reminder (86%) were homozygous for the wild-type allele. The genotype-frequency of the Arg972 IRS-1 variant was (6%) among diabetic patients well controlled with oral therapy and (22 %) among patients with secondary failure to sulfonylurea (odds ratio 1.75, P = 0.041). CONCLUSIONS— These data demonstrate that the E23K Kir6.2 variant and Arg972 IRS-1 variant are associated with increased risk for secondary failure to sulfonylurea, thus representing two potential examples of pharmacogenetics in type 2 diabetes.