Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Second-generation sulfonylureas (SU) are efficacious, generally well-tolerated, cost-effective
options for the medical management of diabetes. Glimepiride which is sometimes classified as a
third-generation has benefits over other in that it has a considerably lower binding affinity for the
B-cell receptor, result in a modulation of insulin release, and a decreased potential for inducing
hypoglycemia.
OBJECTIVE:
This study was designed to evaluate the outcome of using glimepiride and glibenclamide in type 2
diabetic patients.
PATIENTS AND METHODS:
A single blinded randomized clinical trial was adopted, in which 64 already diagnosed diabetic
patients (regardless disease duration) were recruited from Al-Yarmouk hospital, and randomized
into two groups; 1
INTRODUCTION:
Sulfonylureas have been used for type 2 diabetes
for over 50 years
(1)
. They act by stimulating
insulin release from the beta cells of the
pancreas. They bind to sulfonylurea receptors
found on the surface of pancreatic β-cells and
this interaction leads to closure of K
-ATP
channels, the cell membrane is depolarized and
insulin is released
(2)
st
group (32 patients) treated with 5 mg glibenclamide, and 2
group (32
patients) treated with 3 mg glimepride for 4 months. Fasting blood sugar (FBS), glycosylated
hemoglobin (HbA1c) level, triglyceride, cholesterol, serum electrolyte (Na, K, Ca) level and pulse
rate were measured at zero time (first visit)and at the end of the study (after 4 months).
RESULTS:
The result showed that both Fasting blood sugar, glycosylated hemoglobin, serum total cholesterol,
triglyceride levels were decreased significantly in both treatment group but with greater reduction
in group 2, serum electrolytes were not significantly affected, except calcium level which was
increased significantly in glimepiride group only. Moreover, no significant effect observed
regarding pulse rate compared to pretreatment period.
CONCLUSION:
Glimepride provide more potent glycemic control and better lipid profile compared to
glibenclamide in type 2 diabetic patients