title: [A prospective randomized study of sulphonylureas therapeutic interchange in patients with type 2 diabetes mellitus].
abstract: OBJECTIVE
  To clinically assess effectiveness of therapeutic interchange from glibenclamide to gliclazide in the hospital setting.
  
  
  METHODS
  An open-label prospective, randomized study with two groups of patients: a reference group (patients still receiving their previous outpatient regimen of glibenclamide) and an interchange group (patients with gliclazide substituted for glibenclamide according to a hospital-approved interchange protocol). The efficacy endpoint used was blood glucose at 3 and 6 days post-intervention. A patient with blood glucose < 200 mg/L was considered clinically controlled, and blood glucose changes < or > 30 mg/dL were considered significant.
  
  
  RESULTS
  One hundred and sixteen patients were randomized. Blood glucose on the day before the intervention was 177.9 mg/dL +/- 63.4 in the reference group versus 171.3 mg/dL +/- 52.1 in the interchange group (p = 0.92). Mean blood glucose during the first 3 days post-intervention was 156.1 mg/dL +/- 47.5 and 177.7 mg/dL +/- 36.0 (p = 0.14) in the reference and interchange groups, respectively; and mean values for the first 6 days post-intervention were 142.1 mg/dL +/- 36.0 and 172.8 mg/dL +/- 28.2, respectively (p = 0.01). The overall analysis of blood glucose levels showed a better control in the reference group versus baseline values, which was not seen in the interchange group, where blood glucose remained stable and similar to baseline. In no case were 3-day and 6-day blood glucose mean levels above 200 mg/dL, which may be considered acceptable within the hospital setting.
  
  
  CONCLUSIONS
  Therapeutic interchange may be safely performed with no clinical impairment, but better controls were achieved in the reference group.
authors.affiliation: Servicio de Farmacia, Hospital Universitario Son Dureta, Palma de Mallorca. rfarmacia@hsd.es
authors.forename: M
authors.initials: M
authors.lastname: Crespí Monjo
authors.forename: O
authors.initials: O
authors.lastname: Delgado Sánchez
authors.forename: P
authors.initials: P
authors.lastname: Ventayol Bosch
authors.forename: A
authors.initials: A
authors.lastname: Lafuente Fló
authors.forename: M
authors.initials: M
authors.lastname: Pinteño Blanco
authors.forename: A
authors.initials: A
authors.lastname: Escrivá Torralva
authors.forename: F
authors.initials: F
authors.lastname: Puigventós Latorre
authors.forename: I
authors.initials: I
authors.lastname: Martínez-López
mesh_terms: D000284:Administration, Oral; D000368:Aged; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005907:Gliclazide / Q000008:administration & dosage*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D011446:Prospective Studies; D013453:Sulfonylurea Compounds / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D005907:Gliclazide