Efficacy of glimepiride/metformin fixed-dose combination vs metformin uptitration in type 2 diabetic patients inadequately controlled on low-dose metformin monotherapy: A randomized, open label, parallel group, multicenter study in Korea

Abstract

Aims/IntroductionTo compare the efficacy and safety of early combination therapy with glimepiride/metformin to metformin uptitration in reducing glycated hemoglobin (HbA1c) levels in Korean type2 diabetic patients inadequately controlled on low-dose metformin monotherapy. Materials and MethodsIn a randomized, open label, parallel group, multicenter study, 209 Korean type2 diabetic patients (HbA1c 7.0-10.0%, on metformin 500-1,000mg/day) received glimepiride/metformin fixed-dose combination (G/M FDC) or metformin uptitration treatment (Met UP). The primary end-point was the change in HbA1c from baseline to week24. ResultsG/M FDC therapy provided significantly greater adjusted mean decreases vs Met UP therapy in HbA1c (-1.2 vs -0.8%, P<0.0001), and fasting plasma glucose (-35.7 vs -18.6mg/dL, P<0.0001). A significantly greater proportion of patients with G/M FDC therapy achieved HbA1c<7% (74.7 vs 46.6%, P<0.0001) at the end of the study. More patients experienced hypoglycemia with G/M FDC therapy compared with Met UP therapy (41 vs 5.6%, P<0.0001), but there was no serious hypoglycemia in any group. A modest increase in mean bodyweight occurred in the patients who were treated with G/M FDC therapy (1.0kg), whereas a slight decrease was observed in the patients who were treated with Met UP therapy (-0.7kg). ConclusionThe present study showed that glimepiride/metformin fixed-dose combination therapy was more effective in glycemic control than metformin uptitration, and was well tolerated in type2 diabetic patients inadequately controlled by low-dose metformin monotherapy in Korea. This trial was registered with ClinicalTrial.gov (no. NCT00612144).