Efficacy of Glimepiride in Patients with Poorly Controlled Insulin-treated Type 2 Diabetes Mellitus

Abstract

Abstract. We retrospectively investigated the effects of adding glimepiride in patients with type 2 diabetes showing suboptimal control by insulin therapy. Of 63 patients with poorly controlled insulin-treated type 2 diabetes (baseline HbA1c, 8.4 ± 0.6%), 32 were treated with insulin alone and 31 were given glimepiride in addition to insulin. HbA1c values, daily insulin dose, body weight, blood pressure, plasma lipid concentrations, and the number of hypoglycemic events were recorded at weeks 0, 12, 24, 36, 48, 60, and 72. HbA1c decreased by 1.1%, from 8.5 ± 0.6% to 7.4 ± 0.8% (P<0.0001) in patients treated with insulin plus glimepiride at 12 weeks, and improved glycemic control continued throughout the study. Required insulin dose was reduced significantly in patients treated with insulin plus glimepiride (from 29.4 ± 14.5 to 22.3 ± 12.1 units/day, P = 0.0187). Body weight increased significantly in patients treated with insulin plus glimepiride (from 57.0 ± 8.7 to 59.5 ± 9.2 kg, P = 0.0232). Adding glimepiride showed little effect on blood pressure, plasma total cholesterol, triglyceride, or HDL-cholesterol. Serum C peptide concentrations increased significantly in patients treated with insulin plus glimepiride (from 1.01 ± 0.71 to 1.28 ± 0.65 ng/ml, P = 0.0367). The number of hypoglycemic events did not differ between groups. Adding glimepiride to insulin therapy resulted in sustained improvement of glycemic control in patients with poorly controlled type 2 diabetes.

The Influence of Sitagliptin on Treatment-Related Quality of Life in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Prespecified Sub-Analysis

“…In this regard, treatment with insulin plus metformin [5] and α-glucosidase inhibitors [6], but not pioglitazone [7] or sulfonylurea [8], were advantageous in avoiding both weight gain and hypoglycemia. However, there are treatment-limiting side effects with α-glucosidase inhibitors or metformin such as gastrointestinal symptoms [6, 9].…”

Rationale, design, and baseline characteristics of a clinical trial for prevention of atherosclerosis in patients with insulin-treated type 2 diabetes mellitus using DPP-4 inhibitor: the Sitagliptin Preventive study of Intima-media thickness Evaluation (SPIKE)

“…One of the strategies is a reduction in insulin dose by stimulation of endogenous insulin secretion and increased insulin sensitivity using OHA. In fact, treatment with insulin plus metformin [12] and alpha glucosidase inhibitors [13], but not pioglitazone [5] or sulfonylurea [14], were advantageous in avoiding both weight gain and hypoglycaemia. However, there are treatment-limiting side effects for each specific drug.…”

Adding glimepiride to current insulin therapy increases high-molecular weight adiponectin levels to improve glycemic control in poorly controlled type 2 diabetes

“…However, it is still unclear whether glimepiride treatment in T2D patients could increase serum HMW adiponectin level to improve glycemic control. And limited studies have reported that combination therapy with glimepiride and insulin could improve glycemic control and reduce insulin requirements [18,19], but the mechanisms are not clear. Therefore, the present study was conducted to analyze the relationship between the degree of lowering HbA1c and serum HMW adiponectin levels and provide predictors of which patients would benefit from addition glimepiride in poorly controlled T2D subjects with insulin therapy.…”