Author(s)

Hirohisa Onuma, Kouichi Inukai, Masaki Watanabe, Yoshikazu Sumitani, Toshio Hosaka, Hitoshi Ishida

Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Watanabe Medical Clinic, Hiroshima, Japan.

We investigated whether long-term glimepiride (GP) monotherapy improves insulin resistance and exerts a beneficial effect on beta cell function, as compared with glibenclamide (GC). One hundred Japanese Type 2 diabetic patients were randomly assigned to the GP (n = 50) or the GC (n = 50) group. During a 5-year monitoring period, patients received the indicated SU monotherapy, while changes in SU doses were allowed as needed to maintain HbA1C below 7.0%. The GC group, in parallel with fasting insulin, showed a rapid homeostatic model assessment (HOMA)-R increase and maintained a high HOMA-R level. In contrast, HOMA-R in the GP group decreased continuously, from 2.9 at baseline to 1.8 at study completion. In the GC group, HOMA-b was markedly increased in the first 6 months, then gradually decreased through 18 months. While the HOMA-β elevation in the GP group was more moderate than that in the GC group, HOMA-β levels were maintained with a slight decrease. The cumulative macrovascular disease outcome was 1 for the GP and 7 for the GC group, showing a significant difference. These results suggest that glimepiride monotherapy markedly improved HOMA-R with moderate insulin stimulation, which may account for the difference in macrovascular disease development as compared with the group receiving glibenclamide.

Glibenclamide; Glimepiride; Macrovascular Events; HOMA-R/β

Onuma, H. , Inukai, K. , Watanabe, M. , Sumitani, Y. , Hosaka, T. and Ishida, H. (2014) Effects of long-term monotherapy with glimepiride vs glibenclamide on glycemic control and macrovascular events in Japanese Type 2 diabetic patients. Journal of Diabetes Mellitus, 4, 33-37. doi: 10.4236/jdm.2014.41006.