Comparative efficacy and safety of glimepiride-metformin versus glibenclamide-metformin combination in type-2 diabetics uncontrolled with metformin alone

Objectives: The objectives of this study was to compare the efficacy of Glimepiride+Metformin versus Glibenclamide+Metformin combination on HbA1c levels in Type-2 DMand to compare the adverse effects of Glimepiride+Metformin and Glibenclamide+Metformin combination. Methodology: A total of 92 patients whose diabetes was uncontrolled with Metformin therapy alone were selected for the study. They were randomly assigned equally into 2 groups of 46 each as group A and group B.Group A received FDC of Glimepiride 1mg + Metformin 500mg once daily oral for 3 months. Group B received FDC Glibenclamide 5mg+Metformin 500mg once daily oral for 3 months. Patients were assessed at baseline, 1st, 2nd and 3rd month using the parameters: FBS, PPBS and HbA1c at baseline and 3rd month. Adverse effects: hypoglycaemic events and weight were noted during each follow-up. Results: Both the groups significantly reduced HbA1c, FBS and PPBS when compared to baseline. Comparison between the groups showed statistically significant reduction of HbA1c in Glimepiride+Metformin FDC than in Glibenclamide + Metformin FDC. The overall incidence of hypoglycaemic events and weight gain were found to be less in Glimepiride combination. Conclusion: An analysis of the results of all the parameters of efficacy and safety indicates Glimepiride 1mg may be a better choice over Glibenclamide 5mg to combine with Metformin in Type-2 Diabetes Mellitus uncontrolled with Metformin alone