2336-PUB: Treatment Effectiveness of Glimepiride Alone and in Combination with Other Oral Hypoglycemic Agents: Outcomes from Real Clinical Practice

Aim: To assess the treatment effect of glimepiride monotherapy and combination with metformin, DPP-4 inhibitors (DPP-4i) and SGLT2 inhibitor (SGLT2i) in patients with type 2 diabetes mellitus (T2DM).

Methods: A retrospective cross-sectional data analysis of T2DM patients of Apollo Sugar Clinics, Pan India. An eligible glimepiride prescriptions with a diagnosis of T2DM from Jan 2016 to September 2018 were included in this analysis to assess the role of glimepiride as monotherapy and in combination therapy with metformin, DPP-4i and SGLT2i on glycemic variables- glycated haemoglobin (HbA1c), and fasting blood glucose (FBG), and on weight (Wt) and body mass index (BMI). Descriptive statistics were applied to analyze the data and paired t-test was used to identify the significant difference in the glycemic variable within groups.

Results: Total 7059 T2DM patients were included in the analysis. Mean age was 52.9 year, 62.6% were males and 37.4% were females. At initiation the mean (SD) HbA1c was 8.1(1.7)%, FBG 158(55) mg/dL, Wt 69.3(12.5) kgs, and BMI was 26.6(4.7)kg/m2. Of the total, a majority of the patients were on glimepiride and metformin combination (86.3%) followed by glimepiride monotherapy (8.3%), glimepiride and DPP-4i (5%) and glimepiride and SGLT2i (0.4%). The analysis shows significant reduction in HbA1c (0.4%; p <0.001) and FBG (17mg/dL; p <0.001) in glimepiride and metformin combination treatment only compared to other combinations. Further, there was a considerable reduction in BMI in glimepiride and SGLT2i combination.

Conclusions: Our current study shows glimepiride and metformin combination therapy is highly prescribed and is effective in glycemic control compared to monotherapy and other glimepiride combinations.