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Clinical Diabetes & Therapeutics
Combination Therapy of Oral Hypoglycemic Agents in Patients with Type 2 Diabetes Mellitus
Min Kyong Moon, Kyu-Yeon Hur, Seung-Hyun Ko, Seok-O Park, Byung-Wan Lee, Jin Hwa Kim, Sang Youl Rhee, Hyun Jin Kim, Kyung Mook Choi, Nan-Hee Kim
Diabetes Metab J. 2017;41(5):357-366.   Published online October 24, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.5.357
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  • 17 Web of Science
  • 15 Crossref
AbstractAbstract PDFPubReader   

The Korean Diabetes Association (KDA) recently updated the Clinical Practice Guidelines on antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus (T2DM). In combination therapy of oral hypoglycemic agents (OHAs), general recommendations were not changed from those of the 2015 KDA guidelines. The Committee on Clinical Practice Guidelines of the KDA has extensively reviewed and discussed the results of meta-analyses and systematic reviews of effectiveness and safety of OHAs and many clinical trials on Korean patients with T2DM for the update of guidelines. All OHAs were effective when added to metformin or metformin and sulfonylurea, although the effects of each agent on body weight and hypoglycemia were different. Therefore, selection of a second agent as a metformin add-on therapy or third agent as a metformin and sulfonylurea add-on therapy should be based on the patient's clinical characteristics and the efficacy, side effects, mechanism of action, risk of hypoglycemia, effect on body weight, patient preference, and combined comorbidity. In this review, we address the results of meta-analyses and systematic reviews, comparing the effectiveness and safety among OHAs. It will help to choose the appropriate drug for an individual patient with T2DM.

Citations

Citations to this article as recorded by  
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    Medicinal Chemistry Research.2024; 33(3): 337.     CrossRef
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    Asian Journal of Chemistry.2023; 35(4): 887.     CrossRef
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    Ashok Kumar Das, Banshi Saboo, Rajeev Chawla, S. R. Aravind, Rajesh Rajput, Awadhesh K. Singh, J. J. Mukherjee, Ashok Jhingan, Parag Shah, Vaishali Deshmukh, Shailaja Kale, Shalini Jaggi, G. R. Sridhar, Rajnish Dhediya, Kumar Gaurav
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    Sri Nitya Reddy Induri, Payalben Kansara, Scott C. Thomas, Fangxi Xu, Deepak Saxena, Xin Li
    Annual Review of Pharmacology and Toxicology.2022; 62(1): 85.     CrossRef
  • Role of resveratrol supplementation in regulation of glucose hemostasis, inflammation and oxidative stress in patients with diabetes mellitus type 2: A randomized, placebo-controlled trial
    Wajiha Mahjabeen, Dilshad Ahmed Khan, Shakil Ahmed Mirza
    Complementary Therapies in Medicine.2022; 66: 102819.     CrossRef
  • Letrozole: Pharmacology, toxicity and potential therapeutic effects
    Anirban Goutam Mukherjee, Uddesh Ramesh Wanjari, Dhanushya Nagarajan, Vibhaa K K, Anagha V, Joshua Paul P, Tharani Priya T, Rituraj Chakraborty, Kaviyarasi Renu, Abhijit Dey, Balachandar Vellingiri, Abilash Valsala Gopalakrishnan
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    Juyoung Shin, Hyunah Kim, Hun-Sung Kim, Churlmin Kim, Whan-Seok Choi
    Korean Journal of Family Medicine.2021; 42(4): 269.     CrossRef
  • Treatment intensification in type 2 diabetes management after the failure of two oral hypoglycemic agents: A non‐interventional comparative study
    Sirajudeen Shaik Alavudeen, Sultan M. Alshahrani, Easwaran Vigneshwaran, Noohu Abdulla Khan, Javid I. Mir, Abubakr T. M. Hussein
    International Journal of Clinical Practice.2021;[Epub]     CrossRef
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    European Journal of Medicinal Chemistry.2020; 207: 112742.     CrossRef
  • Letter: Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial (Diabetes Metab J 2019;43;276-86)
    Hannah Seok, Tae Seo Sohn
    Diabetes & Metabolism Journal.2019; 43(4): 545.     CrossRef
  • A Survey of the Structures of US FDA Approved Combination Drugs
    Pradipta Das, Michael D. Delost, Munaum H. Qureshi, David T. Smith, Jon T. Njardarson
    Journal of Medicinal Chemistry.2019; 62(9): 4265.     CrossRef
  • Experimental design methodology for optimization and robustness determination in ion pair RP-HPLC method development: Application for the simultaneous determination of metformin hydrochloride, alogliptin benzoate and repaglinide in tablets
    Marianne A. Mahrouse, Nesrine T. Lamie
    Microchemical Journal.2019; 147: 691.     CrossRef
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    Scientific Reports.2018;[Epub]     CrossRef
  • Effect of Lifestyle Modification and Oral Anti-Diabetic Drugs on Metabolic Parameters in Recently Diagnosed Patientswith Uncomplicated Type 2 Diabetes Mellitus in Eastern India
    Nikhilesh Pradhan, Sidhartha Das, Anoj Kumar Baliarsinha, Ashirbad Parhi, Bijan Patnaik, Pramod Kumar Rout
    Journal of Diabetes Mellitus.2018; 08(02): 9.     CrossRef
  • Failure of monotherapy in clinical practice in patients with type 2 diabetes: The Korean National Diabetes Program
    Ja Young Jeon, Soo Jin Lee, Sieun Lee, Soo Jin Kim, Seung Jin Han, Hae Jin Kim, Dae Jung Kim, Young Seol Kim, Jeong Taek Woo, Kyu Jeung Ahn, Moonsuk Nam, Sei Hyun Baik, Yongsoo Park, Kwan‐Woo Lee
    Journal of Diabetes Investigation.2018; 9(5): 1144.     CrossRef
Original Article
Clinical Care/Education
Efficacy of Moderate Intensity Statins in the Treatment of Dyslipidemia in Korean Patients with Type 2 Diabetes Mellitus
Sung Hye Kong, Bo Kyung Koo, Min Kyong Moon
Diabetes Metab J. 2017;41(1):23-30.   Published online December 16, 2016
DOI: https://doi.org/10.4093/dmj.2017.41.1.23
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  • 82 Download
  • 9 Web of Science
  • 8 Crossref
AbstractAbstract PDFPubReader   
Background

There has been evidences of ethnic differences in the low density lipoprotein cholesterol (LDL-C) lowering effect of statin. We aimed to evaluate the efficacy of moderate-intensity statins in the treatment of dyslipidemia among Korean patients with type 2 diabetes mellitus (T2DM).

Methods

We analyzed a retrospective cohort that consisted of Korean patients with T2DM aged 40 to 75 years who had been prescribed any of the moderate-intensity statins (atorvastatin 10 or 20 mg, rosuvastatin 5 or 10 mg, pitavastatin 2 mg, or pravastatin 40 mg). Among them, only patients with baseline lipid profiles before starting statin treatment were selected, and changes in their lipid profiles before and 6 months after statin therapy were analyzed.

Results

Following the first 6 months of therapy, the overall LDL-C reduction was −47.4% (interquartile range, −56.6% to −34.1%). In total, 92.1% of the participants achieved an LDL-C level of <100 mg/dL, 38.3% had a 30% to 50% reduction in their LDL-C levels, and 42.3% had a reduction in their LDL-C levels greater than 50%. The response rates of each drug for achieving a LDL-C level <100 mg/dL were 81.7%, 93.1%, 95.0%, 95.0%, 96.5%, and 91.7% for treatment with atorvastatin doses of 10 or 20 mg, rosuvastatin 5 or 10 mg, pitavastatin 2 mg, and pravastatin 40 mg, respectively.

Conclusion

In conclusion, the use of moderate-intensity statins reduced LDL-C levels less than 100 mg/dL in most of the Korean patients studied with T2DM. The efficacies of those statins were higher than expected in about 42% of Korean patients with T2DM.

Citations

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    Jaecheol Moon, Soyeon Yoo, Gwanpyo Koh, Kyung-Wan Min, Hyun Ho Shin
    Journal of Lipid and Atherosclerosis.2020; 9(1): 162.     CrossRef
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    Mahn-Won Park, Gyung-Min Park, Seungbong Han, Yujin Yang, Yong-Giun Kim, Jae-Hyung Roh, Hyun Woo Park, Jon Suh, Young-Rak Cho, Ki-Bum Won, Soe Hee Ann, Shin-Jae Kim, Dae-Won Kim, Sung Ho Her, Sang-Gon Lee, George C.M. Siontis
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  • Letter: Efficacy of Moderate Intensity Statins in the Treatment of Dyslipidemia in Korean Patients with Type 2 Diabetes Mellitus (Diabetes Metab J 2017;41:23-30)
    Jae-Han Jeon
    Diabetes & Metabolism Journal.2017; 41(2): 150.     CrossRef
  • Response: Efficacy of Moderate Intensity Statins in the Treatment of Dyslipidemia in Korean Patients with Type 2 Diabetes Mellitus (Diabetes Metab J 2017;41:23-30)
    Sung Hye Kong, Bo Kyung Koo, Min Kyong Moon
    Diabetes & Metabolism Journal.2017; 41(2): 152.     CrossRef
Review
Improving Patients' Adherence to Physical Activity in Diabetes Mellitus: A Review
Shan-hu Qiu, Zi-lin Sun, Xue Cai, Lili Liu, Bingquan Yang
Diabetes Metab J. 2012;36(1):1-5.   Published online February 17, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.1.1
  • 4,240 View
  • 51 Download
  • 44 Crossref
AbstractAbstract PDFPubReader   

Regular physical activity (PA) is a key element in the prevention and management of type 2 diabetes mellitus (T2DM). Participation in regular PA improves blood glucose control and can prevent or delay T2DM and its complications, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. However, most people with T2DM are not active and show poor adherence. This paper reviews the possible barriers to PA and strategies to improve the adherence to PA. Based on the currently available literature, it is concluded that self-efficacy and social support from family, friends, and health care providers play the important role in adoption and maintenance of regular PA. Here we also highlight some new modern and innovative interventions that facilitate exercise participation and improve the adherence.

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Original Articles
Factors Influencing Physical Activity Behavior among Iranian Women with Type 2 Diabetes Using the Extended Theory of Reasoned Action
Alireza Didarloo, Davoud Shojaeizadeh, Hassan Eftekhar Ardebili, Shamsaddin Niknami, Ebrahim Hajizadeh, Mohammad Alizadeh
Diabetes Metab J. 2011;35(5):513-522.   Published online October 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.5.513
  • 28,609 View
  • 34 Download
  • 15 Crossref
AbstractAbstract PDFPubReader   
Background

Findings of most studies indicate that the only way to control diabetes and prevent its debilitating effects is through the continuous performance of self-care behaviors. Physical activity is a non-pharmacological method of diabetes treatment and because of its positive effects on diabetic patients, it is being increasingly considered by researchers and practitioners. This study aimed at determining factors influencing physical activity among diabetic women in Iran, using the extended theory of reasoned action in Iran.

Methods

A sample of 352 women with type 2 diabetes, referring to a Diabetes Clinic in Khoy, Iran, participated in the study. Appropriate instruments were designed to measure the desired variables (knowledge of diabetes, personal beliefs, subjective norms, perceived self-efficacy, behavioral intention and physical activity behavior). The reliability and validity of the instruments were examined and approved. Statistical analyses of the study were conducted by inferential statistical techniques (independent t-test, correlations and regressions) using the SPSS package.

Results

The findings of this investigation indicated that among the constructs of the model, self efficacy was the strongest predictor of intentions among women with type 2 diabetes and both directly and indirectly affected physical activity. In addition to self efficacy, diabetic patients' physical activity also was influenced by other variables of the model and sociodemographic factors.

Conclusion

Our findings suggest that the high ability of the theory of reasoned action extended by self-efficacy in forecasting and explaining physical activity can be a base for educational intervention. Educational interventions based on the proposed model are necessary for improving diabetics' physical activity behavior and controlling disease.

Citations

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Efficacy of Sitagliptin When Added to Ongoing Therapy in Korean Subjects with Type 2 Diabetes Mellitus
Hye Soo Chung, Moon-Kyu Lee
Diabetes Metab J. 2011;35(4):411-417.   Published online August 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.4.411
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AbstractAbstract PDFPubReader   
Background

To evaluate the clinical efficacy of sitagliptin for reducing plasma glucose levels in Korean subjects with type 2 diabetes mellitus during a 14-week treatment period.

Methods

Our study design involved the addition of 100 mg sitagliptin once-daily to three ongoing combination therapy regimens and changing from glimepiride and metformin to sitagliptin and metformin.

Results

The addition of sitagliptin 100 mg/day produced a statistically significant reduction in mean HbA1c level (mean HbA1c reduction of 0.99±0.85%, P<0.01). In the group taking a combination of sitagliptin and metformin (n=143, initial mean HbA1c level=7.48%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 0.72±0.76% (P<0.01), 47±65 mg/dL (P<0.01), and 15±44 mg/dL (P<0.01), respectively. In the group taking a combination of sitagliptin, glimepiride, and metformin (n=125, initial mean HbA1c level=8.42%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 1.09±0.86% (P<0.01), 62±64 mg/dL (P<0.01), and 31±45 mg/dL (P<0.01), respectively. In the group taking a combination of sitagliptin, glimepiride, metformin, and α-glucosidase inhibitor (n=63, initial mean HbA1c level=9.19%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 1.27±0.70% (P<0.01), 72±65 mg/dL (P<0.01), and 35±51 mg/dL (P<0.01), respectively. In the group that had previous hypoglycemic events and that changed from glimepiride to sitagliptin, HbA1c level did not change but fasting glucose increased significantly (14±29 mg/dL, P<0.01).

Conclusion

Sitagliptin combination therapy for 14 weeks significantly improved glycemic control and was well-tolerated in Korean subjects with type 2 diabetes mellitus.

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Effect of Diabetes Education Program on Glycemic Control and Self Management for Patients with Type 2 Diabetes Mellitus.
Ji Hyun Kim, Sang Ah Chang
Korean Diabetes J. 2009;33(6):518-525.   Published online December 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.6.518
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AbstractAbstract PDF
BACKGROUND
Diabetes mellitus is a chronic disease requiring continuous treatment and vigorous self-management. Reinforcement of effective self management and diabetes education are important factors in successful treatment. The aim of this study was to evaluate the effectiveness of the current diabetes education program on blood glucose control, self-management, and self-efficacy of patients with type 2 diabetes mellitus. METHODS: A total of 592 patients with newly diagnosed or uncontrolled type 2 diabetes mellitus were recruited to the diabetes education program from January to December 2007. We surveyed 338 patients from April to July 2008. A total of 117 patients had biochemical examinations and completed a questionnaire about knowledge, self-management and self-efficacy of diabetes treatment (no education group (n = 23), education group (n = 94)). RESULTS: The total scores from the questionnaires and the results of laboratory data showed no differences between the two groups. However, there were significant reductions in hemoglobin A1c level in the education group, as compared with the no education group (P = 0.039). Although the score for knowledge about diabetes mellitus was significantly higher in the education group (P = 0.005), greater knowledge was not reflected in the self-management or self-efficacy of the patients. CONCLUSION: The current diabetes education program had no effect on the self-management or self-efficacy of patients with diabetes, although did show some degree of association with blood glucose control and diabetes knowledge level. We conclude that a more effective diabetes education program needs to be developed and applied to daily practice for the improvement ofself-efficacy in patients with diabetes mellitus.

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Randomized Controlled Trial
Efficacy and Safety of Mitiglinide in Korean Type 2 Diabetic Patients: Prospective Randomised Multicenter Comparative Phase III Study.
Se Young Kim, Hyo Jeong Kim, Kyung Ah Han, Se Hyun Baek, Hyun Sik Son, Bong Soo Cha, Kyung Wan Min
Korean Diabetes J. 2007;31(2):163-174.   Published online March 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.2.163
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AbstractAbstract PDF
BACKGROUND
Mitiglinide, one of the meglitinides, is expected to prevent postprandial hyperglycemia of type 2 diabetes by enhancing early phase insulin secretion. The aim of this study was to verify the efficacy and safety of mitiglinide compared to nateglinide. METHODS: One hundred eleven of diabetic patients were randomised and administered of mitiglinide (n = 56) and nateglinide (n = 55) before a meal time for 12 weeks. The changes of HbA1c, fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) were analyzed. The safety of this drug was investigated as well. RESULTS: The change of HbA1c was not significantly different between two groups (-0.77 +/- 1.08% in mitiglinide vs. -0.66 +/- 0.79% in nateglinide, P = 0.57). The reduction of FPG (-12.2 +/- 25.0 mg/dL vs. -6.1 +/- 22.3 mg/dL, P = 0.218), PPG 1 hr (-48.0 +/- 47.1 mg/dL, vs. -29.4 +/- 43.2 mg/dL, P = 0.051), and PPG 2 hr (-59.2 +/- 58.0 mg/dL vs. -43.3 +/- 59.0 mg/dL, P = 0.194) were not significantly different between the mitiglinide and the nateglinide, respectively. Drug-related adverse effects were not different between two groups (16.1% in mitiglinide vs. 27.8% in nateglinide, P = 0.137). The frequency of hypoglycemic events were not different between two groups (8.9% in mitiglinide vs. 14.8% in nateglinide, P = 0.339). There were two patients who had complained shoulder pain in the mitiglinide or deterioration of visual acuity in the nateglinide, but those were found to be unrelated with medications. CONCLUSION: This study showed that mitiglinide had reduced HbA1c as similar to nateglinide and that significantly improved HbA1c, FPG and PPG during 12 weeks of treatment. The safety of mitiglinide was also comparable to nateglinide. Mitiglinide could be used as an effective glucose-lowering agent by enhancing early insulin secretion and reducing postprandial glucose excursion, and thereby might contribute long-term cardioprotective effect in Korean type 2 diabetic patients.

Citations

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  • Monotherapy in Type 2 Diabetes Mellitus Patients 2017: A Position Statement of the Korean Diabetes Association
    Sang Youl Rhee
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    Sang Youl Rhee, Hyun Jin Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Kyung Mook Choi, Jin Hwa Kim
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Original Article
Analysis of Insulin Injection Focused Self-Care and Related Factors in Diabetics.
Joo Wha Yoo, Moon Ja Suh
Korean Diabetes J. 2003;27(2):153-164.   Published online April 1, 2003
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AbstractAbstract PDF
BACKGROUND
The purposes of this study were to investigate the level of insulin injection focused self-care, in patients with diabetes mellitus, and to identify the relationship between the perceived sensitivity/severity, perceived benefits, perceived barriers, self-efficacy and situational barriers relating to the insulin injection focused self-care. METHODS: The data were collected from Type 2 diabetic patients (n=120), at an outpatients clinic of a University Hospital in Seoul, Korea, between March and May 2001. The reliability of the instrument ranged from 0.64 to 0.87 Cronbach's Alpha. The data were analyzed using the SPSS PC+, version 10.0 software: descriptive statistics were conducted for the characteristics of the sample. T-tests, Pearson correlation coefficients and multivariate multiple regression analyses were conducted to identify the associations between the cognitive-affective factors and the insulin injection focused self-care. RESULTS: 1) The average level of self-injection was 4.72+/-.45. The average of coping with hypoglycemia was 2.98 .57. The average self-monitored blood glucose was 2.83 1.15. Among these three insulin injection focused self-care activities, the average for both the coping with hypoglycemia and self-monitored blood glucose were lower than the average for self-injection. 2) The mean scores for perceived sensitivity/severity, perceived benefits, perceived barriers, self-efficacy and situational barriers were 3.32+/-.97 (range 1-5); 3.74+/-.65, 2.49+/-.76, 72.86+/-16.70 (range 10-100) and 1.10+/-.19 (range 1-4), respectively. 3) The education was significantly correlated with the insulin injection focused self-care (p=.012), but the age was not. The frequency of the self-monitoring was significantly correlated with the insulin injection-focused self-care (p=.000) and self- efficacy (p=.000). 4) The self-efficacy was significantly positively correlated with the insulin injection focused self-care (p<.01) and perceived benefits (p<.01), but negatively correlated with situational barriers (p<.05). The perceived benefits were significantly positive correlated with the insulin injection focused self-care (p<.01) and the perceived sensitivity/severity (p<.05). The perceived barriers was also significantly positively correlated with the perceived sensitivity/severity (p<.05). CONCLUSION: Our results suggest that improving the level of insulin injection focused self-care may be increased by increasing the self-efficacy, perceived benefits and perceived sensitivity/severity, and by improving the capabilities for problem solving with the situational barriers faced. Since the purposed of this study was investigate the level of insulin injection focused self-care, rather than the overall management of diabetics, there is the need to develop substantial data to support nursing interventions for the improvement of self-care in patients with diabetes mellitus.
Randomized Controlled Trial
Efficacy and Safety of Glimepiride: A Novel Sulfonylurea Drug compared with Gliclazide in the Treatment of Type 2 Diabetes Mellitus: an Open , Randomized Comparative Multi - Center Clinical Study.
Sung Kwan Hong, Ki Up Lee, Yeon Sang Oh, Ho Young Son, Kwang Won Kim, Hyun Chul Lee, Kyung Rae Kim, Dong Seop Choi, Ie Byung Park, Young Seol Kim, Kwan Woo Lee, Hong Kyu Lee, Soon Hyun Shin
Korean Diabetes J. 1999;23(1):87-97.   Published online January 1, 2001
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AbstractAbstract PDF
BACKGROUND
Glimepiride (HOE490, Amaryl (R)) is a new, third generation sulfonylurea, which binds to a different protein of the sulfonylurea receptor than other sulfonylureas. Although there have been many studies proving the efficacy of glimepiride on Caucasian diabetic patients, only a few studies are available on Asian diabetic patients. We performed an open, randomized, comparative multicenter clinical trial to assess the efficacy and safety of glimepiride in Korean type 2 diabetic patients. METHOD: We recruited 262 type 2 cliabetic patients at 12 different university hospitals whose blood glucose was not controlled effectively with diet alone. Patients were randomized to 1~2mg glimepiride or 40~80mg gliclazide depending on the fasting blood glucose level. Doses were increased stepwise, up to 8mg for glimepiride (once-daily) and 320mg for gliclazide (>80 mg as dividedose) respectively, until metabolic control (fasting blood glucose < 7.9 mmol/L) or maximum dose was achieved. The quality of rnetabolic control was assessed by fasting blood glucose and HbA 1c as primary variables. Insulin, C-peptide and weight were monitored as secondary variables. Safety was assessed by obtaining patient history and laboratory values of relevant variables. RESULTS: Of the 262 patients randomized to treatment, 160(61%) patients completed the 18-week study. The rate of successful blood glucose control (3.9

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