Is sulphonylurea therapy effective long term? A 3-year study with gliclazide

Area of Science:

• Endocrinology
• Metabolic Disorders
• Pharmacology

Background:

• Non-insulin-dependent diabetes mellitus (NIDDM) is characterized by impaired glucose regulation.
• Overweight individuals with NIDDM often struggle to achieve optimal glycemic control despite dietary interventions.
• Elevated plasma lipids and increased platelet adhesiveness are common comorbidities in NIDDM.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of gliclazide in overweight NIDDM patients with suboptimal glycemic control.
• To assess the impact of gliclazide on glycemic profile, lipid levels, body weight, and platelet function.

Main Methods:

• A 36-month prospective study involving 50 overweight NIDDM patients.
• Patients were treated with gliclazide at doses ranging from 40 to 320 mg daily.
• Key parameters monitored included daily plasma glucose, lipid profiles, body weight, and platelet adhesiveness.

Main Results:

• Significant reduction in mean daily plasma glucose levels from 15.2 +/- 0.7 to 6.9 +/- 0.2 mmol/l after 36 months.
• Marked decrease in fasting plasma glucose from 12.7 +/- 0.5 to 6.9 +/- 0.3 mmol/l (p < 0.01).
• Improvements observed in fatty acids, cholesterol, and triglyceride levels; no significant weight gain; and reduced platelet adhesiveness (77.2% to 57.8%).

Conclusions:

• Gliclazide demonstrates significant long-term efficacy in improving glycemic control in overweight NIDDM patients.
• The treatment positively impacts lipid metabolism and platelet function without adverse effects on body weight.
• Gliclazide is a well-tolerated therapeutic option for managing NIDDM, with no reported hypoglycemic episodes or side effects.