title: Diabetes control in the elderly: a randomized, comparative study of glyburide versus glipizide in non-insulin-dependent diabetes mellitus.
abstract: This study sought to compare the efficacy and safety of glyburide and glipizide in elderly patients with well-controlled non-insulin-dependent diabetes mellitus (NIDDM). One hundred forty-five patients aged > or = 65 years with NIDDM that was controlled for at least 3 months with oral sulfonylurea therapy were enrolled. After a washout phase, 139 patients were randomized to receive glyburide, 1.25 or 2.5 mg/day, or glipizide, 2.5 or 5 mg/day. During a 4- to 8-week titration phase, doses were adjusted according to prescribing guidelines. Patients who achieved glycemic control (fasting plasma glucose of < or = 8.9 mmol/L, or 160 mg/dl, on two consecutive occasions) entered a maintenance phase, for a total treatment period of 4 months. Hypoglycemia was defined as a fasting plasma glucose of < 3.3 mmol/L (60 mg/dl) or a random plasma glucose of < 2.8 mmol/L (50 mg/dl), with associated signs and symptoms. Most patients in both the glyburide and glipizide groups achieved satisfactory glycemic control; there were no significant differences between groups in fasting plasma glucose or hemoglobin A1c levels at any time. Of note, the mean dose of glyburide (8.5 mg/day) was approximately half that of glipizide (15.4 mg/day) at the end of the maintenance period (P = 0.009). Both regimens were well tolerated and were associated with a similarly low incidence of hypoglycemia. It was concluded that both glyburide and glipizide are suitable for the treatment of NIDDM in properly selected elderly patients.
authors.affiliation: University of Texas Southwestern Medical Center at Dallas.
authors.forename: J
authors.initials: J
authors.lastname: Rosenstock
authors.forename: P J
authors.initials: PJ
authors.lastname: Corrao
authors.forename: R B
authors.initials: RB
authors.lastname: Goldberg
authors.forename: C
authors.initials: C
authors.lastname: Kilo
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D005913:Glipizide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005905:Glyburide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D016312:Treatment Refusal
chemical_list: D001786:Blood Glucose; D005905:Glyburide; D005913:Glipizide