title: Predictors of response to glimepiride in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  The purpose of DIAMETRE (DIabète et Amarel en Monothérapie. Etude de Titration pour la définition des Répondeurs) was to identify factors predictive of response to glimepiride monotherapy in type 2 diabetic patients in the setting of a prospective multicentre open study.
  
  
  METHODS
  Patients aged 35-70 years with poorly controlled diabetes [fasting plasma glucose (FPG) > or =1,40 g/l and < 3 g/l at baseline] were treated with glimepiride for 6 months, with dosage titrated from 1-6 mg daily, depending on the monthly FPG measurement. Responders were defined as patients with a) FPG < 7.78 mmol/l (1.40 g/l) and HbA(1c) < 7.5% at endpoint, or b) decrease in FPG > or = 20% and/or HbA1c > or = 10%. Stepwise logistic regression analysis was used to identify factors predictive of response.
  
  
  RESULTS
  Of 849 patients evaluable for efficacy, 483 (56.9%) were responders. The response was independently influenced by prior treatment with OADs [OR: 0.399 (0.290-0.549), p=0.0001] and diabetes duration [OR: 0.912 (0.877-0.948), p=0.0001]. Ninety patients (9.2%) experienced 124 episodes of symptomatic hypoglycaemia. Multivariate analysis revealed that a high level of HbA(1c) decreased the risk of symptomatic hypoglycaemia [OR: 0.734 (0.628; 0.858), p=0.0001] whereas a family history of type 2 diabetes doubled this risk [OR: 1.956 (1.246; 3.072), p=0.003].
  
  
  CONCLUSIONS
  This large-scale study, conducted under conditions approximating to current medical practice, confirms that glimepiride has a favourable risk-benefit ratio in type 2 diabetes mellitus. Diabetes duration and previous treatment with OADs reduced the likelihood of being a responder to treatment.
authors.affiliation: CHR Corbeil, Corbeil--Essonnes, France.
authors.forename: G
authors.initials: G
authors.lastname: Charpentier
authors.forename: L
authors.initials: L
authors.lastname: Vaur
authors.forename: S
authors.initials: S
authors.lastname: Halimi
authors.forename: F
authors.initials: F
authors.lastname: Fleury
authors.forename: E
authors.initials: E
authors.lastname: Derobert
authors.forename: A
authors.initials: A
authors.lastname: Grimaldi
authors.forename: V
authors.initials: V
authors.lastname: Oriol
authors.forename: S
authors.initials: S
authors.lastname: Etienne
authors.forename: J J
authors.initials: JJ
authors.lastname: Altman
mesh_terms: D000328:Adult; D000368:Aged; D001053:Apolipoproteins / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000235:genetics; D003925:Diabetic Angiopathies / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012449:Safety; D012907:Smoking; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D001053:Apolipoproteins; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; C057619:glimepiride