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Glibenclamide vs Gliclazide in Type 2 Diabetes of the Elderly
Abstract
The objective of this study was to compare the effect of two sulphonylureas on the frequency of hypoglycaemic events and glycaemic control in elderly patients with Type 2 diabetes. Twenty‐two untreated elderly patients were treated with glibenclamide or gliclazide in a randomized double‐blind fashion. Prior to treatment, a biochemical profile, an oral glucose tolerance test, and a 2‐h hyperglycaemic glucose clamp (glucose 5.4 mmol I‐zs‐1 above baseline) were performed. Patients were seen regularly over 6 months to assess glycaemic control and the frequency of hypoglycaemic reactions. Hyperglycaemic clamp studies and oral glucose tolerance tests were repeated at 1 and 6 months. The area under the curve for the oral glucose tolerance test (glibenclamide: 15.5 ± 0.7; gliclazide: 14.9 ± 0.8 mmol I−1 ((p = NS)) and the haemoglobin A1C (glibenclamide: 7.4 ± 0.2%; gliclazide: 7.9 ± 0.5% (p = NS)) were similar at 6 months. Hypoglycaemic reactions were significantly more frequent with glibenclamide than with gliclazide: 17 vs 4 (p < 0.01). Insulin sensitivity index (ml kg−1 min−1 pmol −1 × 100) was increased significantly by glibenclamide but not gliclazide (glibenclamide: 0.284 ± 0.116 (baseline) vs 0.518 ± 0.102 (6 months) (p < 0.05), gliclazide: 0.260 ± 0.048 (baseline) vs 0.358 ± 0.048 (6 months) (p = NS)). We conclude that glycaemic control was equivalent with the two drugs but the incidence of hypoglycaemic reactions was significantly greater with glibenclamide probably because this drug increases insulin sensitivity to a greater degree.
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“Glyburide is associated with significantly more episodes of severe hypoglycemia than gliclazide (112) because its hypoglycemic effects last for 24 h (111) as a consequence of the presence of active metabolites (111,113).”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [112]
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Metadata
- Authors
- Tessier, D., Dawson, K., Tétrault, J. P., Bravo, G., & Meneilly, G. S.
- Affiliations
- Université de Sherbrooke (CA)
- University of British Columbia (CA)
- Corresponding author
- Tessier, D.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 1994-12
- Volume
- 11
- Issue
- 10
- Pages
- 974-980
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W1972654341
- Cited by
- 116
- References
- 19
- Citations by year
- 2023: 1 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 1 · 2016: 4 · 2015: 5 · 2014: 6 · 2013: 9 · 2012: 9
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Servier
- 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 › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- glibenclamide, gliclazide, sulfonylureas, type 2 diabetes, elderly patients, hypoglycemia, glycemic control, insulin sensitivity, HbA1c, oral glucose tolerance test
- MeSH terms
- Aged, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glyburide, Gliclazide, Humans, Hypoglycemia, Male
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