Advantages of the combined therapy with metformin and glimepiride in patients with type 2 diabetes mellitus
Keywords:type 2 diabetes mellitus, treatment, metformin, glimepiride
AbstractBackground. The use of glimepiride in the therapy of type 2 diabetes mellitus (DM) fewer stimulates the pancreas, keeping its resource, and does not result in hyperinsulinemia, and also provides the highest profile of safety at the lowest stimulation effect on the secretion of insulin. A research aim is determination of efficiency and safety of a combination of metformin and glimepiride during its application in clinical practice for patients with type 2 DM and the level of glycated hemoglobin (HbA1c) 8.5–9.5 %. Materials and methods. Under supervision, there were 29 patients with type 2 DM (duration of the disease was 8.7 ± 3.2 years). Patients were in the state of DM decompensation on a background of therapy with metformin and long acting glyclazide in maximal doses during at least previous three months. Patients received metformin and glimepiride. The initial dose for all patients with type 2 DM was 2,500 mg of metformin and 4 mg of glimepiride. Results. In 3 months after the initial stage, the level of HbA1c significantly decreased — from 9.02 ± 0.41 % to 7.53 ± 0.48 % (p < 0.05). The average reduction in HbA1c after transition to therapy with metformin and glimepiride was 1.49 ± 0.42 %. Efficiency of the additional administration of glimepiride is also confirmed by the high percentage of patients, who achieved the level of HbA1c < 7.0 %, — 13.8 % (p < 0.05). The level of fasting glycaemia decreased from 10.18 ± 1.32 mmol/l to 7.02 ± 1.08 mmol/l in 3 months. The decline achieved 3.07 ± 1.06 mmol/l that in relative expression was –31.2 ± 9.4 % from an initial value. The level of postprandial glycaemia reduced from 11.8 ± 2.14 mmol/l initially to 8.16 ± 1.02 mmol/l in 3 months. The level of postprandial glycaemia decreased by 3.62 ± 1.09 mmol/l that in relative expression was –30.7 ± 10.2 % from the baseline. Conclusions. Taking into account the progressive nature of type 2 DM, glimepiride has advantages over gliclazide of prolonged action, when used in combination with metformin in antidiabetic therapy, especially in patients with long course of DM.
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