Source: Diabetologia  |  Posted 8 years ago

Glimepiride as initial treatment for type 2 diabetes significantly decreases patient body weight and body mass index (BMI) compared to glibenclamide, report researchers.

Although body weight is an important factor in patients with diabetes, it has never been used as a primary endpoint in clinical studies on oral antidiabetic drugs. In this study, S. Martin, MD, German Diabetes Centre at the Heinrich-Heine University, and colleagues retrospectively compared the effect of glimepiride or glibenclamide on body weight in type 2 diabetics treated in routine clinical practice.

The multi-centre, observational study included 802 newly diagnosed type 2 diabetics from 91 clinical practices in Germany, 520 met the inclusion criteria: at least 35 years of age or older, duration of disease for less than 5 years, and BMI of 27 kg/m[^]2[] or higher.

Of the 520 patients, 251 received glimepiride and 269 received glibenclamide for 12 weeks. Primary outcome, change of body weight and BMI, were assessed at treatment initiation and at follow up. Secondary outcomes were changes in variables related to diabetes, such as fasting blood glucose (FBG) cholesterol, and HbA[_]1c[].

At 12-month follow up, significant reductions in body weight and BMI were associated with both treatments ([]P[] < .001). Glimepiride was associated with significantly greater mean weigh loss from baseline to 12-month follow up than was glibenclamide (-2.04 kg vs. -0.58 kg; []P[] < .001). Patients treated with glimepiride also achieved a larger reduction in BMI over 12 months (-0.71 kg/m[^]2[] vs. -0.20 kg/m[^]2[]2; []P[] < .001).

No significant association was found between propensity score, age, sex, or FBG at baseline with change of body weight or change in BMI. Treatment duration at baseline significantly effected treatment outcome ([]P[] = .002), and significantly effected change in BMI ([]P[] = .002).