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Comparison between repaglinide and glipizide in Type 2 diabetes mellitus: a 1‐year multicentre study
Author(s) -
Madsbad S.,
Kilhovd B.,
Lager I.,
Mustajoki P.,
Dejgaard A.
Publication year - 2001
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2001.00490.x
Subject(s) - repaglinide , glipizide , medicine , type 2 diabetes , diabetes mellitus , body mass index , type 2 diabetes mellitus , endocrinology , gastroenterology
Aims To evaluate the long‐term effectiveness and safety of repaglinide, a novel prandial glucose regulator, in comparison with glipizide in the treatment of patients with Type 2 diabetes. Methods Diet or tablet‐treated patients with Type 2 diabetes ( n = 256; age 40–75 years, body mass index (BMI) 20–35 kg/m 2 , HbA 1c 4.2–12.8%), without signs of severe microvascular or macrovascular complications, were included in this double‐blind, multicentre, parallel‐group comparative trial. Patients were randomized at a 2:1 ratio to repaglinide, 1–4 mg at mealtimes, or glipizide, 5–15 mg daily. Results Changes in fasting blood glucose (FBG) and HbA 1c during the 12 months of treatment showed a significant difference in favour of repaglinide. In oral hypoglycaemic agents (OHA)‐naive patients, HbA 1c decreased in the repaglinide and glipizide groups by 1.5% and 0.3%, respectively ( P < 0.05 between groups). Fasting blood glucose decreased in the repaglinide group by 2.4 mmol/l and increased in the glipizide group by 1.0 mmol/l ( P < 0.05 between groups). In the study population as a whole, repaglinide was able to maintain glycaemic control (HbA 1c level) during the 1‐year study period, whereas control deteriorated significantly with glipizide. Change in HbA 1c from baseline was significantly better with repaglinide than with glipizide after 12 months ( P < 0.05). In addition, FBG deteriorated significantly in the glipizide group compared with the repaglinide group ( P < 0.05). No patients in either group experienced a major hypoglycaemic event; the number of patients experiencing minor hypoglycaemia was similar in the repaglinide and glipizide groups (15% and 19%, respectively). Conclusions Repaglinide, given as a prandial glucose regulator, is shown to be an effective and safe treatment of patients with Type 2 diabetes, and is better than glipizide in controlling HbA 1c and FBG levels, overall, and in OHA‐naive patients. Diabet. Med. 18, 395–401 (2001)