The Improvement in Cardiovascular Risk Markers with Glimepiride in Pre-diabetic non-obese Subjects: Similar to Obese Cohort Treated with Metformin | Chapter 13 | Highlights on Medicine and Medical Research Vol. 5

 Background: Over a 5- to 9-year period (mean, 7.20.2), we found that glimepiride was more effective than metformin in delaying the progression from pre-diabetes to type 2 diabetes in non-obese subjects. Metformin was the first-line treatment for newly diagnosed diabetics who were overweight. Furthermore, neither group experienced any deaths or adverse cardiovascular conditions, which could be due to beneficial improvements in lipids and cardiovascular surrogate markers. The impact of interventions on lipids and cardiovascular surrogate markers, on the other hand, was not documented.

Prior to intervention, cardiovascular risk factors such as lipid fractions, such as serum Total cholesterol (TC), Triglyceride (TG), Low Density Lipoprotein Cholesterol (LDLC), High Density Lipoprotein Cholesterol (HDLC), and other markers, such as homocysteine (HomC), highly sensitive C-Reactive Protein (CRP), Fibrinogen (FIBR), and Plasminogen Activator Inhibitor1 (PAI1).

Subjects and Methods: The sample included 18 non-obese subjects, 10 men and 8 women between the ages of 27 and 78, and 20 obese subjects, 10 men and 10 women between the ages of 32 and 81, who had pre-diabetes (fasting plasma glucose of 100 to 125 mg/dl and/or HbA1c of 5.7 to 6.4 percent). The research lasted 5 to 9 years (mean: 7.20.2). Glimepiride was given to non-obese subjects, while metformin was given to obese subjects. At each visit during the study, subjects were counselled on lifestyle intervention (appropriate diet and exercise).Individual lipids and CV markers were compared at the start of the study, six months later, and at the end of the study for each group, as well as between groups for baseline and end-of-study levels.

Results: In the glimepiride group, significant improvements in all parameters occurred after treatment (Post Rx) at 6 months and were sustained until the end of the study. HbA1C ( percent ): 6.2 0.2, 5.5 0.1*, 5.7 0.1*; TC (mg/dl): 212 15, 174 13*, 178 14*; TG (mg/dl): 202 32, 162 28*, 178 14*; LD HDLC was not affected in any way. Obese people who were given metformin experienced similar improvements. There were no major differences between the two groups at the start, 6 months, or end of the research.

Conclusion: Glimepiride is equally efficient in enhancing lipid profiles and cardiovascular surrogate markers in nonobese subjects with Pre diabetes as metformin is in obese subjects, explaining similar cardiovascular results in both classes.

Author (s) Details

Reshma Esmail
Mount Saint Mary College, Los Angeles, California, USA.

Udaya Manohar Kabadi
University of Iowa, Iowa City, Iowa, USA and Des Moines University, Des Moines, Iowa, USA.

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