Comparative efficacy between glimepiride and metformin in preventing progression of prediabetes to type 2 diabetes

Abstract

Background: Several recent studies have shown that treatment with therapeutic lifestyle changes, and/or several drugs retard progression of prediabetes to type 2 diabetes. However, none of these studies used a Sulfonylurea (SU), although in UKPDS, SUs delayed the progression of hyperglycemia and several subjects would have been categorized as having prediabetes by present diagnostic criteria. Thus, SUs may have delayed the progression in this group as well. Objective: Therefore, we examined comparative efficacy of glimepiride and metformin in progression to diabetes in subjects with prediabetes. Methods: Twenty men and 18 women ages 28 - 81 years with prediabetes were followed for 5 - 9 years. Prediabetes was diagnosed by impaired fasting glucose and HbA1Cbetween 5.7% - 6.4% with two consecutive determinations as recommended by American Diabetes Association. Twenty obese subjects were administered metformin 500 mg/day and 18 non obese subjects received glimepiride 0.5 mg/day, in addition to dietary and exercise counseling. Results: Mean duration of follow up was 5.8 ± 0.2 years. Fasting Plasma Glucose (FPG) and HbA1Cdeclined to