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Glibenclamide vs Gliclazide in Type 2 Diabetes of the Elderly
Author(s) -
Tessier D.,
Dawson K.,
Tétrault J.P.,
Bravo G.,
Meneilly G.S.
Publication year - 1994
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 - 10.1111/j.1464-5491.1994.tb00256.x
Subject(s) - medicine , gliclazide , glibenclamide , type 2 diabetes , diabetes mellitus , endocrinology , traditional medicine
The objective of this study was to compare the effect of two sulphonylureas on the frequency of hypoglycaemic events and glycaemic control in elderly patients with Type 2 diabetes. Twenty‐two untreated elderly patients were treated with glibenclamide or gliclazide in a randomized double‐blind fashion. Prior to treatment, a biochemical profile, an oral glucose tolerance test, and a 2‐h hyperglycaemic glucose clamp (glucose 5.4 mmol I ‐zs‐1 above baseline) were performed. Patients were seen regularly over 6 months to assess glycaemic control and the frequency of hypoglycaemic reactions. Hyperglycaemic clamp studies and oral glucose tolerance tests were repeated at 1 and 6 months. The area under the curve for the oral glucose tolerance test (glibenclamide: 15.5 ± 0.7; gliclazide: 14.9 ± 0.8 mmol I −1 (( p = NS)) and the haemoglobin A1C (glibenclamide: 7.4 ± 0.2%; gliclazide: 7.9 ± 0.5% ( p = NS)) were similar at 6 months. Hypoglycaemic reactions were significantly more frequent with glibenclamide than with gliclazide: 17 vs 4 ( p < 0.01). Insulin sensitivity index (ml kg −1 min −1 pmol −1 × 100) was increased significantly by glibenclamide but not gliclazide (glibenclamide: 0.284 ± 0.116 (baseline) vs 0.518 ± 0.102 (6 months) ( p < 0.05), gliclazide: 0.260 ± 0.048 (baseline) vs 0.358 ± 0.048 (6 months) (p = NS)). We conclude that glycaemic control was equivalent with the two drugs but the incidence of hypoglycaemic reactions was significantly greater with glibenclamide probably because this drug increases insulin sensitivity to a greater degree.