Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence.

Rakesh Kumar Sahay,Mahesh Abhyankar,Santosh Revenkar,Sunil Kota,Vinod Mittal,G Raja Gopal,Ghanshyam Goyal

doi:10.7759/cureus.10700

Rakesh Kumar Sahay, Mahesh Abhyankar + Show 5 more

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https://doi.org/10.7759/cureus.10700

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Abstract

ObjectiveTo evaluate the usage of various strengths of glimepiride and metformin fixed-dose combinations in the management of type 2 diabetes mellitus (T2DM) patients with comorbidities and complications.MethodsA retrospective, non-randomized, non-comparative, multi-centric real-world study included T2DM patients (age > 18 years) taking glimepiride and metformin fixed-dose combinations. Age, duration of diabetes, diabetes complications, comorbidities (hypertension and dyslipidemia), dosage frequency, and concomitant medications were analyzed from medical charts.ResultsA total of 4858 T2DM patients were included, with a mean age of 52.67 years and males being predominant in the study population (60.85%). The laboratory investigations showed a mean glycated hemoglobin (HbA1c) of 7.5, low-density lipoprotein (LDL) cholesterol of 104.81 ± 38.19 mg/dL, and serum creatinine of 0.88 ± 0.26 mg/dL. Around 2055 (42.30%) T2DM patients were hypertensive, and telmisartan alone and a telmisartan-based combination were the drugs of choice for hypertension management. Similarly, 1073 (22.08%) T2DM patients were having dyslipidemia and were primarily managed with rosuvastatin and its combination in 664 (62%) patients. Macrovascular complications were observed in 339 (6.97%) T2DM patients, among which coronary artery disease (CAD) had maximum prevalence, affecting 273 (5.61%) T2DM patients. Microvascular complications were 1010 (20.79%) T2DM patients, among which neuropathy had affected a maximum of 686 (14.12%) followed by retinopathy (2.34%) and nephropathy (1.81%). Among the available 11 strengths, the glimepiride 2 mg and metformin 500 mg combination were most widely prescribed in 1297 (26.69%), followed by glimepiride 1 mg and metformin 500 mg in 1193 (24.57%) patients, and the preferred dosage pattern was twice a daily in 2665 (54.85%) T2DM patients. An age-wise prescription analysis showed that glimepiride and metformin combinations were the preferred choice for the management of diabetes across all the age groups.ConclusionThe real-world evidence in the Indian clinical setting indicates that glimepiride and metformin fixed-dose combinations are widely used in the management in T2DM patients with comorbidities like hypertension, dyslipidemia, and diabetes complications. Glimepiride and metformin fixed-dose combinations are suitable for early as well as long-standing diabetes.

Highlights

Diabetes mellitus has become a global burden, affecting 463 million people worldwide and responsible for 4.2 million deaths [1]
An age-wise prescription analysis showed that glimepiride and metformin combinations were the preferred choice for the management of diabetes across all the age groups
The results of the present study indicate good glycemic control at all the age groups and showed a sustained legacy effect maintained for a longer duration of diabetes, which was in concordance with the study conducted by Kalra S et al [4]

Summary

Introduction

Diabetes mellitus has become a global burden, affecting 463 million people worldwide and responsible for 4.2 million deaths [1]. Type 2 diabetes mellitus (T2DM) is a heterogeneous disorder, and patients are at increased risk of developing macrovascular complications (coronary artery disease (CAD), peripheral arterial disease (PAD), and stroke/transient ischemic attack (TIA)) and microvascular complications (diabetic nephropathy, neuropathy, and retinopathy) due to inadequate glycemic control [2]. In India, the epidemic of diabetes continues to rise, which leads to disability and fatal complications that are related to an increased financial burden. How to cite this article Sahay R, Mittal V, Gopal G, et al (September 28, 2020) Glimepiride and Metformin Combinations in Diabetes Comorbidities and Complications: Real-World Evidence. The current study is aimed to analyze the usage of various strengths of the glimepiride and metformin combination in the management of T2DM patients with comorbidities and complications

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Conclusion