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Clinical Utilization Pattern of Multiple Strengths of Glimepiride and Metformin

Abstract

Background: In Indian clinical set-up, modern sulfonylurea, particularly glimepiride is still preferred as an add-on to metformin due to its efficacy, safety and cost effectiveness. In view of this, a case-based questionnaire survey was conducted to analyze the clinical utility of multiple strengths of glimepiride and metformin fixed dose combination in type 2 diabetes mellitus (T2DM).

Methods: The case-based questionnaire survey was conducted with 174 health care professionals across India to assess the use of glimepiride and metformin fixed dose combination according to age, duration of diabetes, body mass index (BMI), diabetes complications, concomitant medications like insulin, and statin.

Results: Overall, data from 2248 patients taking multiple strengths of glimepiride and metformin fixed dose combination were analyzed. All the doses were prescribed across all the age groups and irrespective of duration of diabetes. Overall, 1429 diabetes patients had body mass index (BMI) ≥25 kg/m2, among which 1176 (81.6%) patients were receiving combination of glimepiride 1 or 2 mg and metformin 500 or 850 or 1000 mg. Glimepiride and metformin fixed dose combinations were among the preferred choices in various complications like neuropathy, retinopathy, nephropathy, peripheral vascular disease, diabetic foot and cardiovascular disease. Insulin and statins were co-prescribed in 17.3% and 28.8% patients, respectively. Hypoglycemic episodes were reported in only a minority of patients, even with higher doses of glimepiride and metformin fixed dose combinations.

Conclusion: Multiple strengths of glimepiride and metformin fixed dose combinations are beneficial in T2DM, irrespective of age, duration of diabetes, BMI, diabetes complications, use of concomitant medications such as insulin and statin. Glimepiride and metformin fixed dose combinations were not associated with a significant risk of hypoglycemia.

© Journal of the Association of Physicians of India 2011.

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