Prasanna Kumar K M, Seshadri Krishna, Aravind S R, Deb Prasun, Modi K D, Gopal Raju A, G Vijaya Kumar, Moses Cr Anand, Abhyankar Mahesh, Revenkar Santosh
Department of Endocrinology, Center for Diabetes and Endocrine Care, Bengaluru, IND.
Department of Endocrinology, Apollo Speciality Hospital, Chennai, IND.
Cureus. 2021 Jan 30;13(1):e13020. doi: 10.7759/cureus.13020.
Background 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 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. Methods This 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. Results A 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%). Conclusion This 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.
背景 2 型糖尿病（T2DM）给患者和医疗保健系统都带来了巨大负担。本研究旨在评估接受不同强度格列美脲和二甲双胍联合胰岛素治疗的 T2DM 患者的人口统计学特征。本研究还考察了伴随疾病和治疗方法、治疗持续时间、剂量滴定、糖化血红蛋白（HbA1c）水平、低血糖事件以及治疗过程中的体重变化。方法 这项回顾性、多中心（347 个中心）的观察性研究纳入了接受格列美脲和二甲双胍联合胰岛素治疗的成年 T2DM 患者。在常规护理期间，从经医生认证的病历中收集了与人口统计学特征、病程、合并症、伴随用药和剂量模式相关的数据。结果 本研究共纳入 7058 例患者。纳入患者的中位年龄为 55 岁，约 29% 的患者年龄大于 60 岁，60% 为男性。大多数患者（83.3%）在开始使用格列美脲和二甲双胍联合治疗后开始胰岛素治疗，而其他患者（16.7%）在开始胰岛素治疗后接受格列美脲和二甲双胍联合治疗。平均 HbA1c 水平显著下降，平均变化为 1.33%。三分之一的患者进行了胰岛素剂量下调，这表明添加格列美脲和二甲双胍联合治疗具有胰岛素节省效应。最常见的合并症是高血压（64.7%）。在 3705 例患者中，33.2% 的患者体重减轻，66.8% 的患者体重增加。共有 432 例患者报告发生低血糖事件。医生对疗效和耐受性的总体评估显示在量表上为良好至优秀（分别为 97.3% 和 96.6%）。结论 本研究表明格列美脲和二甲双胍联合胰岛素治疗能有效降低 HbA1c，确保了积极的临床结果。在各年龄组、疾病早期以及病程较长的 T2DM 患者中均观察到良好至优秀的疗效和耐受性。
