Glimepiride (Amaryl®) Provides
Glycemic Control and Weight Loss in Type 2’s
Once daily glimepiride dosages provide effective
glycemic control and result in weight neutralizing
or reducing effects in patients with Type 2 diabetes.
Sulphonylurea compounds induce pancreatic beta
cells to secrete insulin and have been used in
OAD therapy since the 1950s. However, there are
several disadvantages associated with sulphonylurea
treatment, including weight gain and patient non-compliance
due to multiple daily dose requirements.
Glimepiride is a new, well-tolerated sulphonylurea
that appears to have a number of benefits over
older compounds, including once daily dosage,
rapid onset, longer duration of action, and more
effective maintenance of lower insulin levels
in conditions of low blood glucose.
Raimund Weitgasser, MD, of St. Johanns Spital-Salzburg
General Hospital, Salzburg, Austria, and colleagues
conducted an open, uncontrolled study to monitor
the efficacy and safety of glimepiride under routine
conditions in patients with Type 2 diabetes.
Glimepiride was administered once daily at a
dose of 0.5 to 4 mg to 284 patients with a mean
age of 65 years (123 males) for a period ranging
from 4 months to 1.5 years. The drug was substituted
as treatment for patients taking other sulphonylureas
and added to the treatment regimen for patients
taking metformin.
According to Dr. Weitgasser, glimepiride therapy
resulted in reduced levels of hemoglobin A1c (HbA1c)
and body weight at all time points relative to
baseline. Mean intra-individual decreases for
HbA1c compared with baseline (8.4%) were 1.4%,
1.5%, and 1.7% after 4 months, 1, and 1.5 years,
respectively. For body weight, the decreases were
1.9 kg, 2.9 kg and 3.0 kg compared with baseline
(79.8 kg).
In addition, the researchers report that higher
body mass index (BMI), greater age, and monotherapy
correlated with HbA1c reduction, whereas male
gender, lower age and higher BMI predicted body
weight reduction.
Sulphonylureas have a variable degree of blood
glucose decreasing activity that is independent
of their insulin secretion stimulating activity,
and the researchers suggest that, "the weight
neutralizing effects of glimepiride could be due
to the greater extra-pancreatic activity."
They conclude that, in addition to dosing advantages
and extra-pancreatic effects, "glimepiride
has a stable weight neutral or even weight reducing
effect in most patients with Type 2 diabetes."
They add, "This could prove advantageous
for its use as a modern glucose lowering agent."
Diabetes Res Clin Pract 2003 Jul;61:1:13-9.
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DID
YOU KNOW: Tight glycemic control
in diabetic patients undergoing coronary revascularization
has short- and long-term advantages over standard
insulin therapy, a prospective randomized study
has shown.
Administration of a modified glucose-insulin-potassium
(GIK) solution beginning prior to anesthesia and
continuing for 12 hours post surgery enhanced
patients' long-term survival and decreased the
incidence of ischemic events and wound complications,
Dr. Harold L. Lazar reported at the annual meeting
of the American Association for Thoracic Surgery.
