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Comparison between the Therapeutic Effect of Metformin, Glimepiride and Their Combination as an Add-On Treatment to Insulin Glargine in Uncontrolled Patients with Type 2 Diabetes

Title
Comparison between the Therapeutic Effect of Metformin, Glimepiride and Their Combination as an Add-On Treatment to Insulin Glargine in Uncontrolled Patients with Type 2 Diabetes
Author
이창범
Keywords
INDIVIDUALIZING GLYCEMIC TARGETS; ORAL-THERAPY; CONTROLLED-TRIAL; PLUS METFORMIN; MELLITUS; ROSIGLITAZONE; SULFONYLUREA; MANAGEMENT; REGIMENS; FAILURE
Issue Date
2014-03
Publisher
Public Library Science
Citation
Plos One, 2014, 9(3), e87799
Abstract
Aims:To compare the commonly prescribed oral anti-diabetic drug (OAD) combinations to use as an add-on therapy with insulin glargine in patients with uncontrolled type 2 diabetes despite submaximal doses of OADs.Methods:People with inadequately controlled type 2 diabetes (n = 99) were randomly assigned on a 1:1:1 basis to receive insulin glargin, with fixed doses of glimepiride, metformin, and glimepiride plus metformin. Outcomes assessed included HbA1c, the changes in fasting glucose levels, body weight, serum lipids values, insulin dose and symptomatic hypoglycemia.Results:After 24 weeks, HbA1C levels improved from (mean +/- SD) 8.5 +/- 0.9% to 7.7 +/- 0.8% (69.0 +/- 10.0 mmol/mol to 60.8 +/- 8.6 mmol/mol) with insulin glargine plus metformin, from 8.4 +/- 1.0% to 7.7 +/- 1.3% (68.8 +/- 10.6 mmol/mol to 61.1 +/- 14.4 mmol/mol) with insulin glargine plus glimepiride and from 8.7 +/- 0.9% to 7.3 +/- 0.6% (71.7 +/- 9.8 mmol/mol to 56.2 +/- 6.7 mmol/mol) with insulin glargine plus glimepirde plus metformin. The decrease in HbA1c was more pronounced with insulin glargine plus glimepiride plus metformin than with insulin glargine plus metformin (0.49% [CI, 0.16% to 0.82%]; P = 0.005) (5.10 mmol/mol [CI, 1.64 to 8.61]; P = 0.005) and insulin glargine plus glimepiride (0.59% [CI, 0.13% to 1.05%]; P = 0.012) (5.87 mmol/mol [CI, 1.10 to 10.64]; P = 0.012) (overall P = 0.02). Weight gain and the risk of hypoglycemia of any type did not significantly differ among the treatment groups.Conclusion:The combination therapy of metformin and glimepiride plus glargine insulin resulted in a significant improvement in overall glycemic control as compared with the other combinations.
URI
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0087799http://repository.hanyang.ac.kr/handle/20.500.11754/71201
ISSN
1932-6203
DOI
10.1371/journal.pone.0087799
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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