Abstract

The purpose of the present study was to investigate the effect of the first third-generation sulphonylurea drug glimepiride (Amaryl, Aventis) in the treatment of patients with type 2 diabetes mellitus in an open 6-month clinical trial. The study included 19 patients with type 2 diabetes mellitus (7 men and 12 women, aged 53.6 +/- 2.43 years, mean duration of diabetes 7.79 +/- 1.45 years). The body mass index (BMI) of the patients was x = 30.157 +/- 1.63 which is at the borderline between overweight and obesity. The patients started at a baseline dosage of 1 mg which was then it was gradually adjusted according to the blood sugar level. The dosage of the drug varied between 1 and 6 mg (mean daily dosage 2.03 mg). The metabolic control parameters that were calculated included fasting and 2-hour postprandial blood sugar concentration, total cholesterol, serum triglycerides, HbA1c, and microproteinuria. They were measured at baseline, at 3 and 6 months. The results showed that the fasting blood glucose decreased significantly (P<0.05 at 3 months and P<0.001 at 6 months). Statistically significant lower postprandial glycemia was also observed in the patients (the decrease was not significant at 3 months but highly significant at 6 months, P<0.01). The overall evaluation was based on the values of HbA1c--they were statistically significantly lower at 6 months (P<0.01) which suggests the steady improving tendency of the metabolic control in type 2 diabetes patients treated with Amaryl (glimepiride). The improvement of the metabolic control was also manifested by the lower serum triglycerides levels (P<0.05) and the BMI remaining nearly without change. It is concluded that Amaryl (glimepiride) is an efficacious oral sulphonylurea preparation which can be used as an appropriate substitute of the other beta cell stimulators. Glimepiride once daily provides a good compliance of patients which reduces to minimum the skipped doses. It is associated with a reduced risk of hypoglycemia and causes no weight gain.