Weitgasser Raimund, Lechleitner Monika, Luger Anton, Klingler Anton
1st Department of Medicine, St. Johanns Spital - Salzburg General Hospital, Salzburg, Austria.
Diabetes Res Clin Pract. 2003 Jul;61(1):13-9. doi: 10.1016/s0168-8227(02)00254-1.
Sulphonylureas are effective and well tolerated in patients with Type 2 diabetes, but may be associated with weight gain, and lack of compliance due to multiple daily dosing. This open, uncontrolled surveillance study examined the efficacy and safety of glimepiride, a new sulphonylurea, administered once daily in patients with Type 2 diabetes. A total of 1,770 patients were enrolled in the study, and 284 patients were selected for follow-up. Patients received 0.5 to >4 mg glimepiride once daily for 1.5 years. HbA(1c) was reduced from 8.4% at baseline to 7.1% after 4 months and 6.9% after 1 and 1.5 years (median intra-individual change from baseline: -1.4, -1.5, and -1.7%, respectively; P<0.0001). Treatment with glimepiride also resulted in significant and stable weight loss relative to baseline, with the exception of patients with a body mass index of <25 kg/m(2). Mean body weight was reduced from 79.8 kg at baseline to 77.9 kg after 4 months, 77.2 kg after 1 year, and 76.9 kg after 1.5 years (mean intra-individual change from baseline: -1.9 kg, P<0.0001; -2.9 kg, P<0.05; -3.0 kg, P<0.005, respectively). Therefore, once daily glimepiride provides effective glycaemic control, and may have advantages over other sulphonylureas, because it exhibits weight neutralizing/reducing effects in patients with Type 2 diabetes.
磺脲类药物对2型糖尿病患者有效且耐受性良好,但可能会导致体重增加,且因每日多次给药而出现依从性差的问题。这项开放性、非对照监测研究考察了新型磺脲类药物格列美脲每日一次给药对2型糖尿病患者的疗效和安全性。共有1770例患者入组本研究,其中284例患者被选入随访。患者每日一次服用0.5至大于4mg格列美脲,疗程为1.5年。糖化血红蛋白(HbA1c)从基线时的8.4%在4个月后降至7.1%,在1年和1.5年后分别降至6.9%(个体内相对于基线的中位数变化:分别为-1.4%、-1.5%和-1.7%;P<0.0001)。相对于基线,格列美脲治疗还导致体重显著且稳定下降,但体重指数<25kg/m²的患者除外。平均体重从基线时的79.8kg在4个月后降至77.9kg,1年后降至77.2kg,1.5年后降至76.9kg(个体内相对于基线的平均变化:分别为-1.9kg,P<0.0001;-2.9kg,P<0.05;-3.0kg,P<0.005)。因此,每日一次服用格列美脲可有效控制血糖,并且相对于其他磺脲类药物可能具有优势,因为它在2型糖尿病患者中具有体重中和/减轻作用。