The Open Diabetes Journal

2009, 2 : 38-43
Published online 2009 June 29. DOI: 10.2174/1876524600902010038
Publisher ID: TODIAJ-2-38

Measuring Effectiveness of Glimepiride Titration Using SMBG in Patients with Mild Type 2 Diabetes

Akio Kanazawa , Tomoaki Shimizu , Chie Ebato , Yuko Sakurai , Naoki Kumashiro , Shinya Miwa , Takahisa Hirose , Yasushi Tanaka , Ryuzo Kawamori and Hirotaka Watada
Department of Medicine, Metabolism and Endocrinology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.

ABSTRACT

Glimepiride is a potent sulfonylurea agent and is widely used for type 2 diabetic patients, however, the safety and efficacy of glimepiride in patientswith fair diabetic control (HbA1c level: 6.5-7.9%) have not been investigated so far. Therefore, we investigated the safety and efficacy of glimepiride titration using self-monitoring blood glucose (SMBG) in the achievement of strict glycemic control in fairly controlled diabetic patients. Japanese type 2 diabetic patients who were diet-controlled or treated with alpha-glucosidase inhibitor ormetformin, were randomly assigned into the SMBG group with titration of glimepiride using SMBG, or the conventional therapy group (control group) without SMBG. Glimepiride was initiated at a dose of 0.5 mg/day and plasma glucose, insulin, HbA1c and glycoalbumin levels were evaluated for 6 months in both groups. The dose of glimepiride was titrated in the SMBG group according to the SMBG levels before breakfast and dinner. The mean dose of glimepiride at 6 months tended to be higher in the SMBG than the control group (1.0±0.8 vs 0.6±0.3mg/day), but not significant. At 6 months after glimepiride treatment, HbA1c levels were significantly lower than at baseline (SMBG: 7.2±0.5 vs 6.5±0.6%, n=23, P<0.01, control: 7.3±0.4 vs 6.5±0.7%, n=24, P<0.01), although they were similar at 6 months in the two groups. Only three hypoglycemic episodes were recorded among 50 subjects. We found no efficacy of glimepiride titration protocol in this study. However, glimepiride significantly improved glycemic control in fairly controlled diabetic patients without severe hypoglycemia.

Keywords:

Sulfonylurea agent, SMBG, titration.