Comparative study between Metformin, Glibenclamide and their combination in newly diagnosed diabetic (type II) patients in Hawler City

Abstract

Type 2 diabetes mellitus is a complex progressive disorder characterized by impaired insulin sensitivity, reduced insulin secretion and progressive failure
of pancreatic β – cells. Type 2 diabetes therapies are initiated with lifestyle changes (diet, exercise) and pharmacologic agents, including oral antidiabetic
drug, among them: sulphonylurea (glibenclamide), Biguanide (metformin) and combination of them.
The objective of this study is to compare the efficacy of the drugs, both as monotherapy and in combination, and discussed evidence – based treatment.
forty patients with (FPG of 167.9±3.5mg/dl; PPG of 276.3±5.4mg/dl; HbAlcof 8.1±0.2%) were received metformin (500mg tid), and 15 patients with (FPG of 165.1±4.3; PPG of 273.6±5.5; HbAlc of 7.9±0.2) were received glibenclamide (5mg once daily) monotherapy, 35 patients with (FPG of 179±4.1; PPG of 304.4±5.6; HbAlc of 7.9±0.1) were received glibenclamide/metformin (2.5mg/500mg bid) as combination therapy. Blood samples were withdrawn from the patients at pretreatment, then monthly for three months. After 3 months of treatment, patients who received glibenclamide/metformin combination (2.5/500mg) had greater reductions in FPG, PPG and HbAlc (-70.6mg/dl, - 125.3mg/dl, and -2.0% respectively), compared with metformin (-48.8mg/dl, and -88.5mg/dl, -1.6% respectively), or glibenclamide (-52.3mg/dl, -63.5mg/dl, 0.8% respectively). Metformin and glibenclamide/metformin combination had approximately similar effect in reduction of total cholesterol, triglyceride, and low – density lipoprotein cholesterol, compared with glibenclamide alone which showed elevation.
Metformin significantly increased high density lipoprotein cholesterol where as glibenclamide/metformin combination or glibenclamide alone did not
show that, also metformin reduces body weight significantly in contrast to glibenclamide/metformin and glibenclamide alone ( which is associated with
weight gain).
Metformin monotherapy and glibenclamide/metformin combination both are effective as an initial treatment of newly diagnosed diabetic patients in Kurdistan region (Hawler city). These two strategies reduced plasma glucose and HbAlc significantly, and both have favorable effect on serum lipid profile,
but only metformin had a significant reduction of body weight in diabetic patients.