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Glimepiride (By mouth)

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Glimepiride is used to treat high blood sugar levels caused by type 2 diabetes. It may be used alone, or in combination with insulin or another oral medicine such as metformin. In type 2 diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. Using this medicine will help lower blood sugar when it is too high and help restore the… Read more
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What works? Research summarized

Evidence reviews

Glyburide, Gliclazide or Glimepiride for Elderly Patients with Type 2 Diabetes: A Review of the Clinical Effectiveness and Safety – An Update [Internet]

Sulfonylureas are a class of glucose lowering drugs used to treat type 2 diabetes. These drugs bind to sulfonylurea receptors and stimulate closure of adenosine triphosphate sensitive potassium channels to encourage insulin secretion from pancreatic beta cells. Glyburide (also referred to as glibenclamide), gliclazide, and glimepiride are three second-generation sulfonylurea drugs available in Canada. Glyburide has been associated with an increased risk for hypoglycemia and long-term cardiovascular mortality. This may be due to differences in tissue-specific binding of the respective sulfonylureas. A meta-analysis published in 2007 reported an increased risk of hypoglycemia for glyburide compared to other insulin secreting anti-diabetes drugs and alternate sulfonylureas, despite no evidence of improved efficacy. Hypoglycemia can lead to undesirable outcomes including altered mental status, seizures, coma and death. It is more strongly associated with the use of long-acting sulfonylureas (e.g., glyburide and glimepiride) than short-acting sulfonylureas (e.g., gliclazide). The American Geriatrics Society’s Beers Criteria lists a strong recommendation based on high quality evidence that glyburide be avoided in the elderly due to the potential risks. Based on US market pricing, gliclazide is three times higher in price than glyburide, which may contribute to the persistent use of glyburide.

Glimepiride therapy for type 2 diabetes mellitus: a systematic review

Bibliographic details: Liu RM, Jia P, Tang Y.  Glimepiride therapy for type 2 diabetes mellitus: a systematic review. Chinese Journal of Evidence-Based Medicine 2009; 9(10): 1094-1098

Comparative efficacy of glimepiride and metformin in monotherapy of type 2 diabetes mellitus: meta-analysis of randomized controlled trials

BACKGROUND: Metformin treatment has been the most recommended monotherapy of type 2 diabetes mellitus (T2DM) for decades but is challenged by new antidiabetic drugs. This study conducted a meta-analysis of randomized controlled trials (RCT) comparing the efficacy of metformin and glimepiride in monotherapy of T2DM.

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Summaries for consumers

Sitagliptin (Januvia or Xelevia) for type 2 diabetes: Comparing the combination sitagliptin/metformin with glimepiride/metformin

The Institute for Quality and Efficiency in Health Care (IQWiG, Germany) last tested how sitagliptin (trade name: Januvia or Xelevia) compares with standard treatments in 2016. The results of two studies comparing sitagliptin/metformin with glimepiride/metformin were available for analysis. The assessment was based mainly on the longer-lasting of the two studies.

Dulaglutide (Trulicity) for type 2 diabetes: Comparison of the combinations dulaglutide / metformin and sulfonylurea / metformin

In 2015, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of the combination of dulaglutide plus metformin compared with the combination of a sulfonylurea plus metformin in adults with type 2 diabetes. There were no available studies comparing dulaglutide / metformin directly with the approved standard therapies. The data that was analyzed comes from what is called an adjusted indirect comparison of two studies. The results of this kind of comparison are generally less conclusive than the results of a direct comparison. For this analysis, IQWiG used the data from two studies that were sufficiently comparable in terms of participants and dose. One study compared dulaglutide / metformin with sitagliptin / metformin, and the other compared glimepiride / metformin with sitagliptin / metformin.

Albiglutide (Eperzan) for type 2 diabetes: Overview

Albiglutide (trade name: Eperzan) has been approved in Germany since March 2014 for the treatment of type 2 diabetes in adults who cannot lower high blood sugar levels enough through exercise and diet alone.

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