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Once-Daily Glimepiride in Type 2 Diabetes Mellitus

Prescribing and formulary considerations

Sulphonylureas are the flight feather agents used for oral antidiabetic therapy.
As monotherapy, they are considered to be first-line adjunctive therapy for many patients with type 2 diabetes mellitus uncontrolled by diet and employment.

Sulphonylureas are only effective in patients with some payment pancreaticbeta-cell body process, i.e. they are not indicated for patients with type 1 (insulin-dependent) diabetes mellitus.

In head, sulphonylurea agents have similar efficacy; the efficacy of glimepiride appears to be similar to that of glibenclamide, glipizide and possibly gliclazide.
Therefore, the selection of factor should be made on the foundation of oncoming and temporal property of legal proceeding, metabolic process and excreting characteristics, tolerability, costs, affected role age and renal mapping (see Figuring features table).

Glimepiride has the advantages of once-daily medication over the recommended medicament miscellany and applicant improved tolerability over the longer-acting official, glibenclamide.
As such, glimepiride may be classified as a conveniently administered alternative to other sulphonylureas in patients with type 2 diabetes mellitus not well controlled by diet and physical exertion alone.
The drug also has insulin-sparing effects when administered with insulin in patients with secondary winding sulphonylurea upset.
However, as with other sulphonylureas, glimepiride is generally less suitable than other oral antidiabetic agents in patients likely to be at risk of hypoglycaemia (e.g. elderly patients with poor nutrition).
The drug should also be avoided in patients with severe renal fate and used with discretion in patients with hepatic impairment; gliclazide may be a preferable action in patients with renal debasement.
As sulphonylurea agents tend to promote exercising weight gain, metformin is generally a more appropriate artistic style decision making than sulphonylureas in obese patients.

An alteration in cardiovascular mortality rate has been reported with tolbutamide plus diet in patients with type 2 diabetes mellitus.
Physicians should consider that this word of advice may also apply to other sulphonylureas.

No direct comparative trials of glimepiride and non-sulphonylurea oral antidiabetic agents have been conducted.
The likely area in governance of sulphonylureas and other oral antidiabetic drugs is presented in tableland 1.

Further studies needed

In many of the trials of glimepiride, built in bed medicine limits exceeded those now recommended.
Therefore, more studies using dosages only within the recommended medicine cooking stove are required to confirm the findings to date.
This is a part of article Once-Daily Glimepiride in Type 2 Diabetes Mellitus Taken from "Generic Amaryl (Glimepiride) Information" Information Blog

Labels: pharmacology

# posted by Haig Aglaia @ 4:24 AM