title: Efficacy, Safety and Treatment Satisfaction of Glimepiride vs Sitagliptin in Combination with Metformin in Type 2 Diabetes Mellitus.
abstract: BACKGROUND
  Metformin is a preferred drug for starting treatment in type 2 diabetes mellitus. But, eventually most of the patients need additional drug to control blood sugar level. The choice of drug depends upon several factors including patient specific criteria, economical factors and treatment satisfaction.
  
  
  OBJECTIVE
  The aim of the present study is to investigate the effects of adding sitagliptin or glimepiride on efficacy, safety and treatment satisfaction in patients with type 2 diabetes mellitus.
  
  
  METHODS
  It was a retrospective observational study on 50 patients each in sitagliptin and glimepiride group, who are receiving treatment for at least 12 weeks and are stable on respective treatment regimen. Glycated haemoglobin (HBA1c) was the primary measure of efficacy. Safety was assessed by checking weight gain/loss, hypoglycaemia episodes and other laboratory investigations. Patient satisfaction was assessed by Diabetes Treatment Satisfaction Questionnaire.
  
  
  RESULTS
  The HbA1c level after 12-24 weeks of treatment was not found to be significant compared to each other or from baseline. Compared to baseline fasting plasma glucose & postprandial plasma glucose were lower in glimepiride group. Sitagliptin was associated with less episodes of hypoglycaemia. Weight gain was associated with glimepiride but it was non-significant (p=0.08). Overall treatment satisfaction score were better for sitagliptin but were not statistically significant.
  
  
  CONCLUSIONS
  The efficacy of sitagliptin was comparable. Sitagliptin had superior adverse effect profile with less chances of hypoglycaemia and weight gain. Questionnaire scores were higher for sitagliptin indicating better treatment satisfaction compared to glimepiride.
authors.affiliation: Assistant Professor, Department of Pharmacology, SRMSIMS , Bareilly, UP, India .
authors.forename: Subodh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Senior Resident, Department of Pharmacology, IGIMS , Patna, India .
authors.forename: Anuj Kumar
authors.initials: AK
authors.lastname: Pathak
authors.affiliation: Junior Resident, Department of Pharmacology, AIIMS , New Delhi, India .
authors.forename: Dibyajyoti
authors.initials: D
authors.lastname: Saikia
authors.affiliation: Professor, Department of Medicine, SRMSIMS , Bareilly, UP, India .
authors.forename: Amish
authors.initials: A
authors.lastname: Kumar
keywords: Hyperglycaemia; Hypoglycaemia; Treatment satisfaction questionnaire; Weight gain
references.citation: Curr Med Res Opin. 2009 Mar;25(3):569-83
references.pmid: 19232032
references.citation: Diabetes Care. 2006 Dec;29(12):2638-43
references.pmid: 17130197
references.citation: Diabetes Care. 2012 Jun;35(6):1364-79
references.pmid: 22517736
references.citation: Diabetes Obes Metab. 2011 Feb;13(2):160-8
references.pmid: 21199268
references.citation: Lancet. 1998 Sep 12;352(9131):837-53
references.pmid: 9742976
references.citation: J Diabetes Investig. 2014 May 4;5(3):320-6
references.pmid: 24843781
references.citation: Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S474-6
references.pmid: 23565471
references.citation: Diabetes Care. 2006 Dec;29(12):2632-7
references.pmid: 17130196
references.citation: Diabet Med. 1990 Jun;7(5):445-51
references.pmid: 2142043
references.citation: J Pharmacol Pharmacother. 2012 Jul;3(3):273-5
references.pmid: 23129967
references.citation: Diabetologia. 2006 Nov;49(11):2564-71
references.pmid: 17001471
references.citation: Diabetes Care. 2007 Aug;30(8):1979-87
references.pmid: 17485570
references.citation: J Assoc Physicians India. 2012 Mar;60:27-30
references.pmid: 22799111
references.citation: BMJ. 2002 Oct 5;325(7367):746
references.pmid: 12364302
references.citation: Vasc Health Risk Manag. 2012;8:463-72
references.pmid: 23028231
references.citation: Diabetes Ther. 2015 Jun;6(2):153-71
references.pmid: 26040914
references.citation: Diabetes Obes Metab. 2007 Mar;9(2):186-93
references.pmid: 17300594
references.citation: Endocrinol Metab Clin North Am. 1997 Sep;26(3):511-22
references.pmid: 9314012
references.citation: Diabetes Care. 2013 May;36(5):1067-73
references.pmid: 23248197
references.citation: Diabetes Obes Metab. 2007 Mar;9(2):194-205
references.pmid: 17300595
references.citation: Exp Ther Med. 2015 Apr;9(4):1528-1536
references.pmid: 25780464
references.citation: Diabetes Care. 1991 Aug;14(8):738-44
references.pmid: 1954811
references.citation: JAMA. 1999 Jun 2;281(21):2005-12
references.pmid: 10359389
references.citation: Diabetes Obes Metab. 2010 Feb;12(2):167-77
references.pmid: 20092585