The combination of a sulfonylurea with a biguanide improves the pancreatic β-cell
insulin secretion and the insulin utilization in peripheral tissues in NIDDM. This
open, crossover, randomised and prospective study was designed to compare the effects
of the fixed combination glibenclamide-metformin (GL-METF) - 2.5 and 400 mg respectively,
with the fixed combination glibenclamide-phenformin (GL-PHEN) - 2.5 and 25 mg respectively,
on NIDDM diabetes control. Thirty NIDDM patients, in ideal 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 the second group. A statistically significant decrease of post-prandial
blood glucose (p = 0.034) and glycosylated haemo-globin (p < 0.02) values was observed
under GL-METF treatment compared to those with GL-PHEN. The values of lactic acid
were within normal limits during both treatments. The insulin secretion after breakfast
was similar with both drug compounds. The BMI of the patients remained the same during
a follow-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 administration of GL-METF leads to better diabetes control
in NIDDM patients compared to that of GL-PHEN.
Key words
Antidiabetic Tablets - Glibenclamide - Phenformin - Metformin - NIDDM
