Effects on glycemic control by combination therapy of gliclazide-metformin and insulin in type 2 diabetes mellitus patients

Abstract

Background: Diabetes mellitus is one of the most common noncommunicable diseases worldwide, which requires management of the symptoms through lifestyle modification and antidiabetic pharmacotherapies. The purpose of this study was to observe the effects on glycemic control by combination therapy of gliclazide-metformin and insulin in type 2 diabetes mellitus patients according to baseline HbA1c, fasting blood glucose (FBG), and blood glucose 2 h after breakfast. Methods: An observational study was conducted at Endocrinology Outpatient Department of Dhaka Medical College Hospital, Dhaka, and Outpatient Department of Ibrahim General Hospital, Mirpur, Dhaka, for 1 year (July 2018–June 2019). In total, 110 type 2 diabetic patients were selected purposively. The patients were divided into two groups. In Group I, 55 patients treated with gliclazide (80 mg) and metformin (500 mg) combination therapy twice daily for consecutive 12 weeks, and in Group II, 55 patients treated with insulin (premixed 30/70) twice daily for consecutive 12 weeks. Results: After 12 weeks of treatment, HbA1c level reduced from (mean ± standard deviation) 8.94 ± 0.91 to 7.82 ± 1.86 in Group I and 10.07 ± 1.28 to 7.90 ± 1.01 in Group II. FBG level reduced from 10.05 ± 1.57 to 7.96 ± 1.62 in Group I and 11.61 ± 2.62 to 7.60 ± 1.23 in Group II. Blood glucose 2 h ABF level reduced from 14.00 ± 2.04 to 10.99 ± 1.41 in Group I and 16.70 ± 3.61 to 10.71 ± 1.52 in Group II. In Group I, 36.4% of patients achieved HbA1c target level, 40% of patients achieved FBG target level, and 25.5% of patients achieved blood glucose 2 h ABF target level. In Group II, 29.1% of patients achieved HbA1c target level, 56.4% of patients achieved FBG target level, and 29.1% of patients achieved blood glucose 2 h ABF target level. Conclusions: On the basis of the study findings, patients of both study groups showed an improvement in the overall glycemic control (HbA1c, FBG, and blood sugar 2 h ABF) during the study. Both groups of drugs are effective in controlling blood glucose, but individual group has a unique beneficial effect.