Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence

Abstract

Objective To evaluate the usage of various strengths of glimepiride and metformin fixed-dose combinations in the management of type 2 diabetes mellitus (T2DM) patients with comorbidities and complications. Methods A retrospective, non-randomized, non-comparative, multi-centric real-world study included T2DM patients (age > 18 years) taking glimepiride and metformin fixed-dose combinations. Age, duration of diabetes, diabetes complications, comorbidities (hypertension and dyslipidemia), dosage frequency, and concomitant medications were analyzed from medical charts. Results A total of 4858 T2DM patients were included, with a mean age of 52.67 years and males being predominant in the study population (60.85%). The laboratory investigations showed a mean glycated hemoglobin (HbA1c) of 7.5, low-density lipoprotein (LDL) cholesterol of 104.81 ± 38.19 mg/dL, and serum creatinine of 0.88 ± 0.26 mg/dL. Around 2055 (42.30%) T2DM patients were hypertensive, and telmisartan alone and a telmisartan-based combination were the drugs of choice for hypertension management. Similarly, 1073 (22.08%) T2DM patients were having dyslipidemia and were primarily managed with rosuvastatin and its combination in 664 (62%) patients. Macrovascular complications were observed in 339 (6.97%) T2DM patients, among which coronary artery disease (CAD) had maximum prevalence, affecting 273 (5.61%) T2DM patients. Microvascular complications were 1010 (20.79%) T2DM patients, among which neuropathy had affected a maximum of 686 (14.12%) followed by retinopathy (2.34%) and nephropathy (1.81%). Among the available 11 strengths, the glimepiride 2 mg and metformin 500 mg combination were most widely prescribed in 1297 (26.69%), followed by glimepiride 1 mg and metformin 500 mg in 1193 (24.57%) patients, and the preferred dosage pattern was twice a daily in 2665 (54.85%) T2DM patients. An age-wise prescription analysis showed that glimepiride and metformin combinations were the preferred choice for the management of diabetes across all the age groups. Conclusion The real-world evidence in the Indian clinical setting indicates that glimepiride and metformin fixed-dose combinations are widely used in the management in T2DM patients with comorbidities like hypertension, dyslipidemia, and diabetes complications. Glimepiride and metformin fixed-dose combinations are suitable for early as well as long-standing diabetes.

A prospective observational study on safety and efficacy of metformin and its combination used in type-ii diabetes mellitus patients

“…The early combination therapy with glimepiride and metformin is the most commonly used combination, whereas DPP-4 inhibition is the new approach of treatment for T2DM which has the potential to reduce and may even normalize both FPG and PPG concentrations without adverse effects such as weight gain and hypoglycemia. Few studies have reported conflicting results of both tenelipliptin and glimepiride added to metformin regarding the efficacy of antidiabetic agents and safety outcomes [12][13][14][15]. Among 90 patients participated in the study the age ranged between > 30 to <80 maximum were from adulthood (51-60) age group.…”

Effects of Glimepiride Combined with Recombinant Human Insulin Injection on Serum IGF-1, VEGF and TRACP-5b Oxidative Stress Levels in Patients with Type 2 Diabetes Mellitus

“…Glimemil has the characteristics of fast binding to receptors, short time of interaction with membrane receptors, and fast hypoglycemia [13]. It can also increase nonoxidative metabolism by increasing glucose transporters, thereby reducing blood sugar [14,15]. e results of this study showed that the post-treatment insulin resistance index (HOMA-IR), fasting blood glucose (FPG), 2 h postprandial blood glucose (2hBG), serum glycated hemoglobin (HbA1c), triglyceride (TG) in the study group and control group, total cholesterol (TC), serum malondialdehyde (MDA), ROS, VEGF, and TRACP-5b levels were significantly lower than those before treatment, and the degree of reduction in the study group was greater than that in the control group, glimepiride may improve insulin sensitivity, reduces insulin resistance, and has always reduced blood glucose and blood lipids in patients.…”

A Review on Affordable Combinations in Type 2 Diabetes Care: Exploring the Cost-Effective Potential of Glipizide + Metformin and Glimepiride + Metformin + Pioglitazone

“…Another multicenter study conducted in India increased the achievement of glycemic goals and lipid levels without any severe adverse events [59]. Fixed-dose combinations of glimepiride + metformin have been effective in managing T2DM among newly diagnosed and long-standing diabetes patients [60] in India. Kim et al [61] noted significant improvement in the fasting plasma glucose and HbA1c levels with FDC of glimepiride metformin among T2DM patients inadequately managed by low-dose metformin monotherapy.…”