Real-World Observational Study of Glimepiride and Metformin Fixed-Dose Combination Along With Insulin in the Management of Type 2 Diabetes Mellitus: Indian Experience.

Km Prasanna Kumar,Vijaya Kumar G,Prasun Deb,Mahesh Abhyankar,Santosh Revenkar,Sr Aravind,Raju A Gopal,Kd Modi,Krishna Seshadri,Cr Anand Moses

doi:10.7759/cureus.13020

Abstract

BackgroundType 2 diabetes mellitus (T2DM) is associated with a significant burden on both patients and the healthcare system. This study aimed to evaluate the demographics of patients with T2DM receiving different strengths of glimepiride and metformin combination along with insulin. This study also examined the concomitant conditions and therapies, duration of therapies, dosage titration, glycated hemoglobin (HbA1c) levels, hypoglycemic events, and weight changes during the course of therapy.MethodsThis retrospective, multicenter (347), observational study included adult patients with T2DM who received glimepiride and metformin combination along with insulin. Data related to demographic characteristics, duration of disease, co-morbidities, concomitant medications, and dosage pattern was collected from medical records authenticated by physicians during routine care.ResultsA total of 7058 patients were included in the study. The median age of included patients was 55 years and around 29% were aged >60 years and 60% were men. The majority of patients (83.3%) had insulin treatment initiation after glimepiride and metformin combination while other patients (16.7%) received glimepiride and metformin combination after insulin initiation. The mean HbA1c levels significantly decreased with a mean change of 1.33%. In one-third of the patients, down-titration of the insulin dose was done, indicating the insulin-sparing effect with the addition of the glimepiride and metformin combination. The most common comorbid condition was hypertension (64.7%). Of 3705 patients, 33.2% patients had weight loss and 66.8% had weight gain. A total of 432 patients reported hypoglycemic events. Physician global evaluation of efficacy and tolerability showed a good to excellent on the scale (97.3% and 96.6%).ConclusionThis study presented good HbA1c lowering with glimepiride and metformin combination with insulin, ensuring a positive clinical outcome. Good to excellent efficacy and tolerability were observed in patients with T2DM across the age groups, in early as well as long-standing disease.

Highlights

Type 2 diabetes mellitus (T2DM) is predominant in the Asian population, majorly affecting young to middleaged adults, despite low body mass index (BMI) and obesity
This study presented good HbA1c lowering with glimepiride and metformin combination with insulin, ensuring a positive clinical outcome
Patients having incomplete data or any condition that, according to the discretion of the investigator, indicates that the patient is not suitable for inclusion in the study were excluded from the study. The outcome of this observational data analysis was the demographics of patients receiving different strengths of the glimepiride and metformin combination along with different types of insulin, concomitant conditions and therapies, duration of the glimepiride and metformin combination along with insulin therapy, up-titration and down-titration done during the course of therapy, HbA1c levels, hypoglycemic events, and weight change during the course of therapy

Summary

Introduction

Type 2 diabetes mellitus (T2DM) is predominant in the Asian population, majorly affecting young to middleaged adults, despite low body mass index (BMI) and obesity. Sulfonylurea and insulin are among the commonly used drugs when the glycemic goal is not achieved by using metformin monotherapy, especially in Asian countries [2]. How to cite this article Prasanna Kumar K, Seshadri K, Aravind S, et al (January 30, 2021) Real-World Observational Study of Glimepiride and Metformin Fixed-Dose Combination Along With Insulin in the Management of Type 2 Diabetes Mellitus: Indian Experience. Type 2 diabetes mellitus (T2DM) is associated with a significant burden on both patients and the healthcare system. This study aimed to evaluate the demographics of patients with T2DM receiving different strengths of glimepiride and metformin combination along with insulin. This study examined the concomitant conditions and therapies, duration of therapies, dosage titration, glycated hemoglobin (HbA1c) levels, hypoglycemic events, and weight changes during the course of therapy

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