[an error occurred while processing this directive]

Item #13

Glyburide/Metformin Combination Reduces A1c by 1.7% over Sulphonylurea and 1.9% Over Metformin

Glyburide/metformin combination is more effective than either medication alone for type 2 diabetics not adequately controlled combination by sulphonylurea, diet and exercise.

Investigators from the Ochsner Clinic Foundation in New Orleans, Louisiana, United States, assessed the efficacy, safety and tolerability of the combined treatment in 639 patients with type 2 diabetes failing on sulphonylurea therapy.

Patients were randomly assigned to receive combined treatment or monotherapy with glyburide or metformin. A1c levels were measured after 16 weeks of treatment.

Results showed that the combination of glyburide and metformin reduced  A1c levels by 1.7% more than glyburide alone and by 1.9% more than metformin alone. The combination treatment also reduced mean fasting plasma glucose concentrations more that either medication alone.

Overall safety and tolerability were similar among the different treatment groups. Mild to moderate symptoms of hypoglycaemia were reported by more patients on the combined treatment. Also, more patients taking metformin monotherapy reported gastrointestinal problems. Diabetes Obes Metab 2002;4:6:368-375. 

================================

FACT:

A study of the experience of 30 family physicians recorded their view that "early educational interventions for patients with diabetes resulted in better outcomes”. 'The better job you do right at the start of educating them, the longer the effect's going to last. If you just sort of gloss over at the start, they don't really take it seriously.'" Participants described ongoing educational intervention as "a cornerstone of diabetes care."  Brown, J. B., Harris, S. B. et al, "The role of patient, physician and systemic factors in the management of type 2 diabetes mellitus", Family Practice 19(4), 344-8, August 2002

[an error occurred while processing this directive]