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LETTER TO THE EDITOR
Year : 2015  |  Volume : 19  |  Issue : 2  |  Page : 309

Starting with low dose sulfonylurea and metformin in early stage type 2 diabetes mellitus


Baby Memorial Hospital, Kozhikode, Kerala, India

Date of Web Publication14-Jan-2015

Correspondence Address:
Joe George
Baby Memorial Hospital, Kozhikode, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.149334

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How to cite this article:
George J. Starting with low dose sulfonylurea and metformin in early stage type 2 diabetes mellitus. Indian J Endocr Metab 2015;19:309

How to cite this URL:
George J. Starting with low dose sulfonylurea and metformin in early stage type 2 diabetes mellitus. Indian J Endocr Metab [serial online] 2015 [cited 2019 Oct 14];19:309. Available from: http://www.ijem.in/text.asp?2015/19/2/309/149334

Sir,

The combination of Metformin and Sulfonylurea is a well-studied therapy, which addresses both underlying defects of type 2 diabetes mellitus (T2DM) that is, insulin deficiency and insulin resistance. [1]

Of the available low dose glimepiride (0.5 mg, 1 mg and 2 mg) [2] based therapies, combinations with 1 mg and 2 mg of glimepiride and metformin are widely used and well accepted. Recently, we observed the effectiveness of glimepiride 0.5 mg and metformin 500 mg combination in 941 early stage T2DM patients who were followed up for a period of 3 months. There was a 24.5% reduction in fasting blood glucose (baseline: 151 mg/dl, after 3 months: 114 mg/dl), 26.5% reduction in postprandial blood glucose (baseline: 215 mg/dl, after 3 months: 158 mg/dl) and 28.2% reduction in random blood glucose (baseline: 202 mg/dl, after 3 months: 145 mg/dl). The therapy was well-tolerated, and there were no reports of hypoglycemia or weight gain.

This observation is in concordant with earlier studies that low-dose metformin-sulfonylurea combination therapy achieved a good glycemic control, caused least hypoglycemia, weight gain and gastrointestinal disturbances. [3] Thus, initiating a therapy with a combination of glimepiride 0.5 mg and metformin 500 mg can be considered suitable for the management of early stage type 2 diabetic patients, which however needs to be substantiated in future by large-scale randomized studies.

 
   References Top

1.
Riddle M. Combining sulfonylureas and other oral agents. Am J Med 2000;108 Suppl 6a: 15S-22.  Back to cited text no. 1
    
2.
Umayahara R, Yonemoto T, Kyou C, Morishita K, Ogawa T, Taguchi Y, et al. Low-dose glimepiride with sitagliptin improves glycemic control without dose-dependency in patients with type 2 diabetes inadequately controlled on high-dose glimepiride. Endocr J 2014.  Back to cited text no. 2
    
3.
Hermann LS, Scherstén B, Bitzén PO, Kjellström T, Lindgärde F, Melander A. Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. A double-blind controlled study. Diabetes Care 1994;17:1100-9.  Back to cited text no. 3
    




 

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