The effect of glargine versus glimepiride on pancreatic beta-cell function in patients with type 2 diabetes uncontrolled on metformin monotherapy: open-label, randomized, controlled study

Title
The effect of glargine versus glimepiride on pancreatic beta-cell function in patients with type 2 diabetes uncontrolled on metformin monotherapy: open-label, randomized, controlled study
Author(s)
문준성원규장하경수[하경수]이현철[이현철]윤지성이형우
Keywords
INTENSIVE INSULIN THERAPY; TERM GLYCEMIC CONTROL; FOLLOW-UP; APOPTOSIS; SULFONYLUREA; SECRETION; RESISTANCE; MELLITUS; GLIBENCLAMIDE; HYPERGLYCEMIA
Issue Date
201404
Publisher
SPRINGER-VERLAG ITALIA SRL
Citation
ACTA DIABETOLOGICA, v.51, no.2, pp.277 - 285
Abstract
The aim of present study is to assess whether if basal insulin, glargine, could improve insulin secretory function of beta-cells compared with glimepiride when metformin alone was failed. This was an open-label and multi-center study for 52 weeks in Korean patients with uncontrolled type 2 diabetes by metformin monotherapy. Subjects were randomized to glargine or glimepiride groups (n = 38 vs. 36, respectively). The primary endpoint was to compare changes in c-peptide via glucagon test after 48 weeks. Glycemic efficacy and safety endpoints (glycated hemoglobin (HbA1c), HOMA-B, fasting plasma glucose (FPG), lipid profiles, and hypoglycemic events) were also checked. The mean disease duration of all subjects was 88.2 months. Changes in C-peptide was no significant different between groups (P = 0.73), even though insulin secretion was not worsened in both groups at the endpoint. Glargine was not superior to glimepiride in other beta-cell function indexes such as HOMA-B (P = 0.28). HbA1c and FPG reduced significantly in each groups but not different between two groups. Although, severe hypoglycemia did not occur, symptomatic hypoglycemia was more frequent in glimepiride group (P = 0.01). Insulin glargine was as effective as glimepiride in controlling hyperglycemia and maintaining beta-cell function in Korean patients with type 2 diabetes during 48 weeks study period, after failure of metformin monotherapy. Hypoglycemic profile was favorable in the insulin glargine group and less weight gain was observed in the glimepiride group. Our results suggest that glargine and glimepiride can be considered after failure of metformin monotherapy.
URI
http://hdl.handle.net/YU.REPOSITORY/32575http://dx.doi.org/10.1007/s00592-013-0553-z
ISSN
0940-5429
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의과대학 > 내과학교실 > Articles
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