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Lower incidence of severe hypoglycaemia in patients with type 2 diabetes treated with glimepiride versus glibenclamide

Holstein, Andreas, Plaschke, Armin, Egberts, Eick‐Hartwig·2001·Diabetes/Metabolism Research and Reviews
DOI 10.1002/dmrr.235
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Abstract

Background: Severe hypoglycaemia is a potentially life‐threatening condition. The aim of the present study was to compare the frequency of severe hypoglycaemia in patients with type 2 diabetes treated with glimepiride versus glibenclamide. Methods: This prospective, population‐based, 4‐year study examined the incidence of severe hypoglycaemia in a region of Germany with 200 000 inhabitants. The blood glucose of all 30 768 patients who attended the emergency department of the region's central hospital was determined to detect severe hypoglycaemia, which was defined by the requirement for intravenous glucose or glucagon injection and blood glucose value of <2.8 mmol/l. Additionally, 6631/7804 patients (85%) attended to by the emergency medical services received a blood glucose test at the emergency site. The regional prescribing frequency of both sulphonylureas was determined by an independent external institute. Results: Despite glimepiride being prescribed more frequently than glibenclamide (6976 vs 6789 person‐years), glimepiride induced fewer episodes of hypoglycaemia (6 vs 38 episodes); one episode occurred with a combination of the two preparations. The incidence of severe hypoglycaemia was 0.86/1000 person‐years for glimepiride and 5.6/1000 person‐years for glibenclamide. The characteristics of the 45 patients who presented with sulphonylurea‐associated hypoglycaemia were as follows: mean age 79 years (95% CI 75.2; 82.6); glycosylated haemoglobin 5.4% (95% CI 5.1; 5.7); impaired renal function in 62%. Conclusions: In people with type 2 diabetes, glimepiride was associated with fewer episodes of severe hypoglycaemia than glibenclamide in routine clinical use. However, severe hypoglycaemia did occur with glimepiride and may be minimised if treatment targets are determined on an individual basis. Copyright © 2001 John Wiley & Sons, Ltd.

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  • Chlorpropamide and glibenclamide are associated with a substantially greater risk of hypoglycemia than other second-generation sulfonylureas (gliclazide, glimepiride, glipizide, and their extended formulations), which are preferable.

    “Chlorpropamide and glibenclamide (known as glyburide in the U.S. and Canada), are associated with a substantially greater risk of hypoglycemia than other second-generation sulfonylureas (gliclazide, glimepiride, glipizide, and their extended formulations), which are preferable (Table 1) (53,54).”

    From Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy (2009) · cites this paper as [53]

  • In a population-based study in Germany, of 145 episodes of severe hypoglycemia treated in patients with type 2 diabetes attending a hospital emergency department over 4 years, 45 patients were receiving sulfonylureas; glimepiride was implicated in 6 episodes compared with 38 severe events associated with glyburide.

    “A total of 145 episodes of severe hypoglycemia were treated, and 45 of these patients were receiving treatment with sulfonylureas.Although glimepiride had been prescribed more frequently than glyburide, it was implicated in 6 episodes of severe hypoglycemia, compared with a total of 38 severe events associated with glyburide.”

    From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [120]

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Authors
Holstein, A., Plaschke, A., & Egberts, E.
Affiliations
Klinikum Lippe (DE)
Corresponding author
Holstein, Andreas
ORCID
Holstein, Andreas
Venue
Diabetes/Metabolism Research and Reviews
Publisher
Wiley
Published
2001-11
Volume
17
Issue
6
Pages
467-473
ISSN
  • 1520-7552 (ISSN-L)
  • 1520-7560
DOI
10.1002/dmrr.235
OpenAlex
W2014346836
Cited by
264
References
25
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 9 · 2021: 8 · 2020: 3 · 2019: 4 · 2018: 14 · 2017: 12 · 2016: 10 · 2015: 18 · 2014: 21 · 2013: 18 · 2012: 22
FWCI
6.66
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 20 d)
Locations
  • Diabetes/Metabolism Research and Reviews (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords
severe hypoglycemia, type 2 diabetes, glimepiride, glibenclamide, sulfonylureas, hypoglycaemia incidence, emergency department visits, prescribing patterns, renal dysfunction, glycemic control
MeSH terms
Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Germany, Glyburide, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Male, Prospective Studies, Sulfonylurea Compounds

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