Efficacy and safety of insulin glargine combined with glimepiride in type 2 diabetic patients with poor glycemic control

Objective To investigate the efficacy and safety of insulin glarsine(Lantus~(R))combined with glimepiride(Amaryl~(R))in type 2 diabetic patients whose blood glucose levels were inadequately controlled by oral antidiabetic drugs(OAD).Methods In this open-labeled,randomized,parallel,muhicenter,and non-inferiority study,122 patients were given either once.daily insulin glarsine(n=62)or NPH insulin(n=60)at bedtime,plus glimepiride for 24 weeks.Results Baseline characteristics were similar between the two groups.HbA_(1C) levels were decreased in the insulin glargine and NPH groups over the study period in the per-protocol population (1.38% vs 1.41%).Fasting blood glucose(12.30 to 6.05 mmoL/L and 11.90 to 6.19 mmol/L,respectively)and the mean daily blood glucose(6.28 vs 5.72 mmol/L)decreased similarly in beth groups during the study.Moreover.the number of hypoglycemic episodes was significantly lower in patients with insulin glarsine than those with NPH insulin(46.8% vs 71.1%,P<0.05),being particularly severe(3.2% vs 15.0%,P<0.05)and expressing nocturnal hypoglycemia(37.1% vs 61.7%,P<0.01).Daily insulin dose was increased from 9.7 to 32.5 IU in the insulin glarine group and from 9.8 to 29.5 IU in the NPH insulin group.Conclusion These results confirm earlier reports that insulin glargine provides similar glyeemic control with less hypoglycemia compared with NPH insulin. Insulin glargine yields better results in lowering the incidence of severe and nocturnal hypoglycemia. Key words: Glargine; Glimepiride; Diabetes mellitus; type 2