A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital

Shukrath Chandrappa; Shabari Shetty; Arun Thungani Narayana; Kavitha Rajarathna

doi:10.5455/njppp.2024.14.03142202430032024

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10 / 04 / 2024

Natl J Physiol Pharm Pharmacol. 2024; 14(9):

doi: 10.5455/njppp.2024.14.03142202430032024

A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital

Shukrath Chandrappa, Shabari Shetty, Arun Thungani Narayana, Kavitha Rajarathna.

Abstract
Background: Type 2 diabetes mellitus (T2DM) is a chronic disorder with progressive pancreatic β-cell dysfunction and insulin resistance. Hyperglycemia associated with uncontrolled T2DM leads to various diabetes-related complications. Although metformin is the most preferred first-line drug, 5–10% of patients per year subsequently fail to achieve target HbA1c levels, subsequently requiring combination therapy. While efficacy and cost favor the use of sulfonylureas, hypoglycemic episodes limit its use. Newer generation sulfonylureas such as glimepiride and gliclazide are presumed to have lower incidence of hypoglycemia.

Aims and Objectives: The aim of the study was to assess the efficacy and safety of glimepiride versus gliclazide as an add-on to metformin in T2DM.

Materials and Methods: A total of 60 patients with T2DM (HbA1c 7.0–10.0%, on metformin monotherapy) were recruited and randomized into two groups of 30 cases each. Group A received glimepiride 2 mg as add-on to metformin 1500 mg and Group B received gliclazide 80 mg as add-on to metformin 1500 mg. HbA1c, lipid profile, body mass index, and total blood count were assessed at baseline and at the end 12 weeks of treatment. Fasting blood sugar (FBS) and post prandial blood sugar (PPBS) were assessed at the end of 4, 8, and 12 weeks and adverse events were assessed throughout the study period.

Results: There was a significant decrease in HbA1c, FBS, and PPBS scores from baseline to the end of 12 weeks in both groups (P < 0.001), but the difference was not statistically significant between the two groups (P > 0.05). A significant decrease in lipid levels was observed in both groups except for high-density lipoprotein, low-density lipoprotein in the metformin + gliclazide group. The treatment was well tolerated in both groups, with the most common adverse events being nausea, diarrhea, and epigastric pain.

Conclusion: Glimepiride and gliclazide are both equally effective as an add-on to metformin in improving glycaemic indices and are well tolerated in the management of uncontrolled T2DM.

Key words: Glimepiride; Gliclazide; Combination Drug Therapy; Metformin; Diabetes Mellitus; Glycaemic Indices

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How to Cite this Article

Pubmed Style

Chandrappa S, Shetty S, Narayana AT, Rajarathna K. A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital. Natl J Physiol Pharm Pharmacol. Online First: 10 Apr, 2024. doi:10.5455/njppp.2024.14.03142202430032024

Web Style

Chandrappa S, Shetty S, Narayana AT, Rajarathna K. A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital. https://www.njppp.com/?mno=195552 [Access: April 19, 2024]. doi:10.5455/njppp.2024.14.03142202430032024

AMA (American Medical Association) Style

Chandrappa S, Shetty S, Narayana AT, Rajarathna K. A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital. Natl J Physiol Pharm Pharmacol. Online First: 10 Apr, 2024. doi:10.5455/njppp.2024.14.03142202430032024

Vancouver/ICMJE Style

Chandrappa S, Shetty S, Narayana AT, Rajarathna K. A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital. Natl J Physiol Pharm Pharmacol, [cited April 19, 2024]; Online First: 10 Apr, 2024. doi:10.5455/njppp.2024.14.03142202430032024

Harvard Style

Chandrappa, S., Shetty, . S., Narayana, . A. T. & Rajarathna, . K. (2024) A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital. Natl J Physiol Pharm Pharmacol, Online First: 10 Apr, 2024. doi:10.5455/njppp.2024.14.03142202430032024

Turabian Style

Chandrappa, Shukrath, Shabari Shetty, Arun Thungani Narayana, and Kavitha Rajarathna. 2024. A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital. National Journal of Physiology, Pharmacy and Pharmacology, Online First: 10 Apr, 2024. doi:10.5455/njppp.2024.14.03142202430032024

Chicago Style

Chandrappa, Shukrath, Shabari Shetty, Arun Thungani Narayana, and Kavitha Rajarathna. "A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital." National Journal of Physiology, Pharmacy and Pharmacology Online First: 10 Apr, 2024. doi:10.5455/njppp.2024.14.03142202430032024

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Chandrappa, S., Shetty, . S., Narayana, . A. T. & Rajarathna, . K. (2024) A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital. National Journal of Physiology, Pharmacy and Pharmacology, Online First: 10 Apr, 2024. doi:10.5455/njppp.2024.14.03142202430032024

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