Metformin-Glipizide Combo Is More Effective Than
Monotherapy In Type 2
A single-tablet combination of metformin and glibenclamide
is more effective at lowering blood glucose than
is monotherapy with either drug.
Antihyperglycaemic effects of the combination therapy
are greatest in patients with hemoglobin A1c (HbA1c)
equal to or above 8% at baseline, according to investigators,
but its advantage over either monotherapy is irrespective
of baseline HbA1c, age or body mass index.
The investigators,
from multiple international institutions including
Baylor College of Medicine and The Methodist
Hospital in Houston, Texas, United States, and Hôpital
Bichat in Paris, France, studied 1,856 patients from
3 randomized, double-blind, multi-centre, parallel-group
clinical trials. Patients were stratified at baseline
by HbA1c levels, age and body mass index, and the
efficacy of the study treatments were evaluated for
each subgroup.
Results showed that the combination therapy was
more effective than either monotherapy irrespective
of baseline HbA1c, age or body mass index. Patients
with baseline HbA1c at 8% or higher experienced the
greatest antihyperglycemic effects with all treatments,
but especially with the combination therapy.
Age and body mass index had no effect on the efficacy
of the metformin-glibenclamide combination.
Hypoglycemic symptoms were greatest in patients
who had baseline HbA1c lower than 8%. Hypoglycemic
symptoms did not increase with age.
The investigators conclude that the combination
therapy has a greater blood glucose lowering efficacy
than monotherapy. It is well tolerated in patients
with hyperglycemia that has been inadequately controlled
by diet and exercise. Diabetes Obes Metab 2003;5:3:171-179
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DO YOU KNOW
The HHS guidelines state that patients aged 45 years
or older with normal fasting plasma glucose levels
or normal results on oral glucose tolerance tests
should be retested every 3 years. Those with glucose
in the prediabetes range should be counseled on diet
and exercise and be retested every 1-2 years to avert
progression to diabetes.
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