THERAPEUTIC EFFECT OF GLIBENCLAMIDE IN A FIXED COMBINATION WITH METFORMIN OR PHENFORMIN IN NIDDM PATIENTS

The combination of a sulfonylurea with a biguanide improves the pancre atic p-cell insulin secretion and the insulin utilization in periphera l tissues in NIDDM. This open, crossover, randomised and prospective s tudy was designed to compare the effects of the fixed combination glib enclamide-metformin (GL-METF) - 2.5 and 400 mg respectively, with the fixed combination glibenclamide-phenformin (GL-PHEN) - 2.5 and 25 mg r espectively, on NIDDM diabetes control. Thirty NIDDM patients, in idea l metabolic control, who were being treated with GL-PHEN were divided in two groups. One group received GL-PHEN for 12 weeks followed by 12 weeks treatment with GL-METF and the reverse treatment was given to th e second group. A statistically significant decrease of post-prandial blood glucose (p = 0.034) and glycosylated haemo-globin (p < 0.02) val ues was observed under GL-METF treatment compared to those with GL-PHE N. The values of lactic acid were within normal limits during both tre atments. The insulin secretion after breakfast was similar with both d rug compounds. The BMI of the patients remained the same during a foll ow-up study of 24 weeks. Lipid metabolism did not change significantly during the trial and the safety parameters (renal and liver function, full blood count) remained unchanged. In conclusion, the administrati on of GL-METF leads to better diabetes control in NIDDM patients compa red to that of GL-PHEN.