Glimepiride: evidence-based facts, trends, and observations

Abstract

Type 2 diabetes mellitus is characterized by insulin resistance and progressive β cell failure; therefore, β cell secretagogues are useful for achieving sufficient glycemic control. Glimepiride is a second-generation sulfonylurea that stimulates pancreatic β cells to release insulin. Additionally, is has been shown to work via several extra pancreatic mechanisms. It is administered as monotherapy in patients with type 2 diabetes mellitus in whom glycemic control is not achieved by dietary and lifestyle modifications. It can also be combined with other antihyperglycemic agents, including metformin and insulin, in patients who are not adequately controlled by sulfonylureas alone. The effective dosage range is 1 to 8 mg/day; however, there is no significant difference between 4 and 8 mg/day, but it should be used with caution in the elderly and in patients with renal or hepatic disease. In clinical studies, glimepiride was generally associated with lower risk of hypoglycemia and less weight gain compared to other sulfonylureas. Glimepiride use may be safer in patients with cardiovascular disease because of its lack of detrimental effects on ischemic preconditioning. It is effective in reducing fasting plasma glucose, post-prandial glucose, and glycosylated hemoglobin levels and is a useful, cost-effective treatment option for managing type 2 diabetes mellitus.

Therapeutic effects of acupuncture on obesity and HbA1c

“…In non-diabetics with normal HbA 1c levels, acupuncture treatments caused no change in the levels, as acupuncture is not expected to cause a deviation from normal physiologic status. HbA 1c levels in our diabetic patients fell a similar amount (but fell more quickly) as those of diabetic patients on medical therapy in previous studies [29,30]. The relatively rapid decrease in HbA 1c in our patients was greater than the drug-only or diet effect noted in other studies [14,[30][31][32][33].…”

“…In our study, HbA 1c levels fell a mean of 0.6% (max 1.3%) in obese diabetics after only 10-12 weeks of acupuncture treatment. However, vildagliptin or glimepiride did not induce as much weight loss as acupuncture treatment did in our diabetic patients [29,30]. In the literature, there are a few studies regarding the effects of acupuncture on HbA 1c levels.…”

“…In the literature, anti-diabetic medications have been shown to decrease HbA 1c levels up to 0.5-2% [29]. For example, vildagliptin was shown to reduce HbA 1c levels by 0.7% over 8 months [30].…”

Should sulfonylurea be discontinued or maintained at the lowest dose when starting ipragliflozin? A multicenter observational study in Japanese patients with type 2 diabetes

“…In calculating the sulfonylurea dose, we considered 1 mg glimepiride to be equivalent to 40 mg gliclazide or 1.25 mg glibenclamide, as previously reported 14,15 . We calculated propensity scores for the likelihood of discontinuing or maintaining sulfonylurea at the lowest dose as add-on to ipragliflozin using baseline covariates in a multivariate logistic regression model.…”

Glycemic control and cost-effectiveness attained by the drug utilization of oral antidiabetic agents in a tertiary care hospital in South India

“…19,25 Glimepiride on the other hand has favourable pleiotropic cardiovascular effects, low incidence of hypoglycaemia and is the preferred sulfonylurea in obese patients. [26][27][28] Analysing FPG and HbA1C values, pre-treatment and 1 year post treatment of 5 commonly prescribed treatment groups showed that all treatment regimens showed significant reduction in FPG except metformin monotherapy. Fasting plasma glucose is a highly unreliable value for assessing glycemic control since it is dependent on previous day's diet, medication and exercise.…”