Glimepiride (Monograph)
Brand name: Amaryl
Drug class: Sulfonylureas
VA class: HS502
Molecular formula: C24H34N4O5S
CAS number: 93479-97-1
Introduction
Antidiabetic agent; sulfonylurea.1 53
Uses for Glimepiride
Type 2 Diabetes Mellitus
Used alone or in combination with one or more other oral antidiabetic agents or insulin as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.1 5 54 100 101 102 103 104 105 106 107 117
Used in fixed combination with pioglitazone in patients with type 2 diabetes mellitus who are already receiving a thiazolidinedione and a sulfonylurea separately or who do not achieve adequate glycemic control with thiazolidinedione or sulfonylurea monotherapy.117
Current guidelines for the treatment of type 2 diabetes mellitus generally recommend metformin as first-line therapy in addition to lifestyle modifications in patients with recent-onset type 2 diabetes mellitus or mild hyperglycemia because of its well-established safety and efficacy (i.e., beneficial effects on glycosylated hemoglobin [hemoglobin A1c; HbA1c], weight, and cardiovascular mortality).698 704 705
In patients with metformin contraindications or intolerance (e.g., risk of lactic acidosis, GI intolerance) or in selected other patients, some experts suggest that initial therapy with a drug from another class of antidiabetic agents (e.g., a glucagon-like peptide-1 [GLP-1] receptor agonist, sodium-glucose cotransporter 2 [SGLT2] inhibitor, dipeptidyl peptidase-4 [DPP-4] inhibitor, sulfonylurea, thiazolidinedione, basal insulin) may be acceptable based on patient factors.698 704
May need to initiate therapy with 2 agents (e.g., metformin plus another drug) in patients with high initial HbA1c (>7.5% or ≥1.5% above target).698 704 In such patients with metformin intolerance, some experts suggest initiation of therapy with 2 drugs from other antidiabetic drug classes with complementary mechanisms of action.698 704
Consider early initiation of combination therapy for the treatment of type 2 diabetes mellitus to extend the time to treatment failure and more rapidly attain glycemic goals.704
For patients with inadequate glycemic control on metformin monotherapy, consider patient comorbidities (e.g., atherosclerotic cardiovascular disease [ASCVD], established kidney disease, heart failure), hypoglycemia risk, impact on weight, cost, risk of adverse effects, and patient preferences when selecting additional antidiabetic agents for combination therapy.698 699 704 705 706
Consider early introduction of insulin for severe hyperglycemia (e.g., blood glucose ≥300 mg/dL or HbA1c >9–10%), especially if accompanied by catabolic manifestations (e.g., weight loss, hypertriglyceridemia, ketosis) or symptoms of hyperglycemia.698 704
Related/similar drugs
Ozempic, Rybelsus, metformin, Trulicity, Lantus, Tresiba, Victoza
Glimepiride Dosage and Administration
General
-
Adjust dosage according to tolerance and fasting glucose determinations.1 Monitor regularly (e.g., fasting blood or plasma glucose determinations) to determine therapeutic response and minimum effective dosage.1 Monitor HbA1c every 3–6 months to determine the patient’s continued response to therapy.1
-
Use lowest effective dosage (either as monotherapy or in combination regimens) to reduce both fasting glucose concentrations and HbA1c values to normal or near normal.1 17 18 24 31 28
-
If inadequate glycemic control and/or secondary failure occurs during monotherapy with glimepiride, may consider add-on therapy with metformin, insulin, or rosiglitazone.1 With concomitant glimepiride and metformin therapy, adjust dosage to the minimum effective level for each drug.1
Oral Administration
Administer glimepiride alone or in fixed combination with pioglitazone once daily with the first main meal.1 5 6 117
Dosage
Adults
Type 2 Diabetes Mellitus
Glimepiride Monotherapy
OralInitially, 1 or 2 mg of glimepiride once daily for previously untreated patients or patients transferred from other antidiabetic agents.1 In patients receiving 1 mg daily, increase dosage to 2 mg daily after 1–2 weeks if adequate glycemic control has not been achieved.53 Increase dosage in increments of no more than 2 mg daily at 1- to 2-week intervals up to a maximum of 8 mg once daily.1 Usual maintenance dosage is 1–4 mg once daily.1 53
Maximum initial dosage should not exceed 2 mg once daily.1
Glimepiride/Pioglitazone Fixed-combination Therapy
OralSelect initial dosage based on patient’s current dosage of glimepiride (or another sulfonylurea agent) and/or pioglitazone.117
Patients currently receiving glimepiride monotherapy: Usual initial dosage is 2 or 4 mg of glimepiride and 30 mg of pioglitazone once daily.117
Patients transferring from monotherapy with other sulfonylureas: Initially, 2 mg of glimepiride and 30 mg of pioglitazone once daily.117 If patient is being transferred from a sulfonylurea with a long half-life (e.g., chlorpropamide [no longer commercially available in the US]), monitor closely for hypoglycemia during initial 1–2 weeks of the transition period.117
Patients currently receiving pioglitazone monotherapy: Usual initial dosage is 2 mg of glimepiride and 30 mg of pioglitazone once daily.117
Patients switching from concurrent therapy with separate glimepiride and pioglitazone preparations: Initiate fixed combination with 2 or 4 mg of glimepiride and 30 mg of pioglitazone once daily based on patient’s current dosage of glimepiride and pioglitazone.117 While switching therapy, carefully monitor patients whose hyperglycemia was not previously controlled with 15 mg of pioglitazone in combination with glimepiride.117
Gradually titrate dosage as needed based on therapeutic response.117 Allow sufficient time (e.g., 8–12 weeks) to assess response.117 If additional glycemic control is needed, may increase dosage until maximum daily dosage of 8 mg of glimepiride and 45 mg of pioglitazone is reached.117
Patients with type 2 diabetes mellitus and systolic dysfunction: Initiate glimepiride/pioglitazone fixed-combination at the lowest recommended dosage; use fixed-combination preparation only after patient has received pioglitazone 15 mg once daily as monotherapy and has safely tolerated dosage titration to 30 mg once daily.117 If subsequent dosage adjustment required, closely monitor for weight gain, edema, or other manifestations of CHF exacerbation.117
Concomitant Glimepiride and Insulin Therapy
OralInitially, manufacturer recommends 8 mg of glimepiride once daily and a low insulin dosage in patients whose fasting plasma or serum glucose concentration exceeds 150 mg/dL despite appropriate oral antidiabetic monotherapy, diet, and exercise.1
Adjust insulin dosage upward at approximately weekly intervals until adequate glycemic control is achieved.1 53 Periodic adjustments in insulin dosage may be necessary during continued combination therapy.1
Switching Therapy from Other Sulfonylurea Agents
OralInitially, 1–2 mg of glimepiride once daily.1 1 2 May discontinue other sulfonylurea agents immediately.1 2 3 96 When switching therapy from chlorpropamide (a sulfonylurea with a long elimination half-life; no longer commercially available in the US), monitor closely for hypoglycemia during the initial 1–2 weeks of the transition period.1
The initial dosage of glimepiride during the switch from other therapy should not exceed 2 mg daily.1
Prescribing Limits
Adults
Type 2 Diabetes Mellitus
Oral
Glimepiride monotherapy: Maximum 8 mg daily.1
Fixed combination with pioglitazone: Maximum 8 mg of glimepiride and 45 mg of pioglitazone daily.117
Special Populations
Hepatic Impairment
Glimepiride monotherapy: Initially, 1 mg once daily.1 Conservative initial and maintenance dosages recommended.1
Renal Impairment
Glimepiride monotherapy: Initially, 1 mg once daily.1 Titrate dosage upward based on fasting glucose concentrations.1 Dosages >1 mg daily may not be required if Clcr <22 mL/minute.1 8
Geriatric Patients
Geriatric individuals may be particularly sensitive to the hypoglycemic effects of glimepiride.1
Glimepiride monotherapy: Initially, 1 mg once daily.1 Titrate dosage upward with care.1 Conservative initial and maintenance dosages recommended.1 53
Debilitated or Malnourished Patients
These individuals may be particularly sensitive to the hypoglycemic effects of glimepiride.1
Glimepiride monotherapy: Initially, 1 mg once daily.1 Conservative initial and maintenance dosages recommended.1
Cautions for Glimepiride
Contraindications
-
Known hypersensitivity to glimepiride or any ingredient in formulation.1
-
Diabetic ketoacidosis, with or without coma.1
Warnings/Precautions
Warnings
Cardiovascular Effects
Increased cardiovascular mortality reported with certain other antidiabetic agents (i.e., tolbutamide, phenformin).1 99 However, the American Diabetes Association (ADA) considers the benefits of intensive glycemic control with insulin or sulfonylureas to outweigh the risks overall.31 58 64 99
General Precautions
Hypoglycemia
Possible severe hypoglycemia, especially in geriatric, debilitated, or malnourished patients and those with adrenal, pituitary, hepatic, or renal insufficiency.1 Increased risk of hypoglycemia with strenuous exercise, alcohol ingestion, insufficient caloric intake, or use in combination with other oral antidiabetic agents (e.g., rosiglitazone, metformin).1
Hypoglycemia may be difficult to recognize in geriatric patients and in those receiving β-adrenergic blocking agents.1
Appropriate patient selection and careful dosing are important to avoid glimepiride-induced hypoglycemia.1
Loss of Glycemic Control
Possible loss of glycemic control during periods of stress (e.g., fever, trauma, infection, surgery); administration of insulin may be required.1
Efficacy of therapy may decrease over time (secondary failure).1 Addition of metformin or insulin to therapy may be required.1 54 (See Diabetes Mellitus under Uses.)
Use of Fixed Combinations
When used in fixed combination with pioglitazone or other drugs, consider the cautions, precautions, and contraindications associated with pioglitazone or other concomitant agent(s).117
Specific Populations
Pregnancy
Category C.1
Many experts recommend use of insulin during pregnancy to maintain optimum control of blood glucose concentrations.1
Lactation
Distributed into milk in rats; other sulfonylureas distributed into human milk.1 Use not recommended.1 If oral antidiabetic therapy discontinued and diet alone is inadequate for optimal glycemic control, consider institution of insulin.1
Pediatric Use
Glimepiride: Safety and efficacy not established in children <16 years of age.1 53
Fixed combination with pioglitazone: Safety and efficacy not established in pediatric patients.117
ADA states that use of oral antidiabetic agents may be considered in children with type 2 diabetes mellitus because of the greater compliance and convenience and lack of evidence demonstrating better efficacy of insulin for type 2 diabetes mellitus.93
Geriatric Use
No substantial differences in safety, efficacy, or pharmacokinetics relative to younger adults, but increased sensitivity cannot be ruled out.1
Possible increased risk of adverse effects due to age-related decreases in renal function.1 Renal function monitoring recommended, and care should be taken in dosage selection.1 (See Geriatric Patients under Dosage and Administration.)
Increased risk of hypoglycemia; may be difficult to recognize in geriatric patients.1
Hepatic Impairment
Increased risk of hypoglycemia; conservative dosing recommended.1 (See Hepatic Impairment under Dosage and Administration.)
Renal Impairment
Decreased clearance.1
Increased risk of hypoglycemia; conservative dosing recommended.1 (See Renal Impairment under Dosage and Administration.)
Common Adverse Effects
Dizziness, asthenia, headache, nausea.1
Drug Interactions
Metabolized by CYP2C9.1
Drugs Affecting Hepatic Microsomal Enzymes
Pharmacokinetic interactions likely with drugs that are inhibitors and inducers of CYP2C9; possible alteration in metabolism of glimepiride.1
Protein-bound Drugs
Potential pharmacokinetic interaction (increased hypoglycemic effect).1 (See Specific Drugs under Interactions.)
Close observation recommended when initiating or discontinuing concomitant therapy with a highly protein-bound drug.1
Drugs with Hyperglycemic Effects
Potential pharmacologic interaction (loss of glycemic control).1
Close observation recommended when initiating or discontinuing concomitant therapy.1
Specific Drugs
Drug |
Interaction |
Comments |
---|---|---|
ACE inhibitors (e.g., ramipril) |
No evidence of clinically important adverse interactions in clinical studies1 |
|
Antifungals, oral (i.e., miconazole) |
Increased hypoglycemic effect; severe hypoglycemia reported1 |
Not known whether interaction occurs with IV, topical, or vaginal antifungal dosage forms1 |
β-Adrenergic blocking agents (e.g., propranolol) |
Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 Increased peak plasma concentrations and half-life and decreased clearance of glimepiride with concomitant propranolol1 |
Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 No evidence of clinically important adverse interactions in clinical studies1 |
Calcium-channel blockers |
No evidence of clinically important adverse interactions in clinical studies1 |
|
Chloramphenicol |
Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 |
Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 |
Corticosteroids |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
Coumarin anticoagulants (e.g., warfarin) |
Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 No change in warfarin protein binding with concomitant administration but slight decrease in pharmacodynamic response1 |
Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 No clinically important pharmacokinetic interaction with warfarin reported1 |
Diuretics (e.g., thiazides) |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
Estrogens |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 No evidence of clinically important adverse interactions in clinical studies1 |
Fluconazole |
Increased AUC and half-life of glimepiride143 |
Concomitant use may increase the risk of hypoglycemia143 |
H2-receptor antagonists (e.g., cimetidine, ranitidine) |
No clinically important pharmacokinetic interactions observed.1 |
|
HMG-CoA reductase inhibitors (statins) |
No evidence of clinically important adverse interactions in clinical studies1 |
|
Hormonal contraceptives |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
Isoniazid |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
MAO inhibitors |
Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 |
Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 |
Niacin |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
NSAIAs |
Potential for increased hypoglycemic effect1 No evidence of clinically important adverse interactions in clinical studies1 |
Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 |
Phenothiazines |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
Phenytoin |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
Probenecid |
Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 |
Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 |
Rifampin |
Decreased AUC and half-life of glimepiride144 No clinically important pharmacodynamic interactions reported144 |
|
Salicylates (e.g., aspirin) |
Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 Increased glimepiride clearance with concomitant aspirin (1 g 3 times daily); no change in blood glucose concentrations or evidence of hypoglycemia1 |
Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 No evidence of clinically important adverse interactions in clinical studies1 |
Sulfonamides |
Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 No evidence of clinically important adverse interactions in clinical studies1 |
Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 |
Sympathomimetic agents |
Potential for decreased hypoglycemic effect1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
Thyroid hormones |
Potential for decreased hypoglycemic effect1 No evidence of clinically important adverse interactions in clinical studies1 |
Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 |
Glimepiride Pharmacokinetics
Absorption
Bioavailability
Completely absorbed; oral bioavailability of 100%.1 Peak blood concentrations attained within 2–3 hours.1
Onset
Time to maximum effect about 2–3 hours.1
Duration
Glucose-lowering effect persists for 24 hours.1
Food
Food increases the time to peak blood concentrations by about 12%.1 The mean peak blood concentration and AUC are decreased by 8 and 9%, respectively.1
Distribution
Extent
Volume of distribution: 8.8 L (113 mL/kg).1
Not known if glimepiride is distributed into human milk.1
Plasma Protein Binding
>99.5%.1
Elimination
Metabolism
Metabolized by CYP2C9 and by cytosolic enzymes to active and inactive metabolites.1
Elimination Route
Excreted in urine (60%) and feces (40%) predominantly as metabolites.1
Half-life
Averages 5.3 hours after a single dose in healthy individuals.1 Averages 9.2 hours in patients with type 2 diabetes mellitus at steady state.1
Special Populations
Renal impairment: Decreased serum drug concentrations and increased concentrations and half-lives of the metabolites.1
Geriatric patients: At steady state, lower mean AUC (13%) and increased clearance (11%) compared with younger patients.1
Stability
Storage
Oral
Tablets
Glimepiride: Well-closed containers at 15–30°C.1
Actions
-
Reduces both fasting and postprandial blood glucose concentrations and HbA1c in a dose-dependent manner.1 5 6 20
-
Lowers blood glucose concentration principally by stimulating postprandial secretion of endogenous insulin from the beta cells of the pancreas.1 9 10 11 28 54 Also enhances peripheral sensitivity to insulin.1 2 3 5 6 49 50
-
Provides overall glycemic control without appreciably increasing fasting insulin secretion.1 2 3 5 6 49 50
-
Ineffective in the absence of functioning beta cells.1
Advice to Patients
-
Inform patients of the potential risks and advantages of glimepiride therapy and of alternative forms of treatment.1
-
Importance of taking the medication each morning with breakfast or with the first main meal.1
-
Importance of adhering to diet and exercise regimen.1 13 15 16
-
Importance of hygiene and avoidance of infection.31
-
Advise patients about the nature of diabetes mellitus, prevention and detection of complications, and importance of glycemic control.18 31 22
-
Importance of appropriate management of hypoglycemia and hyperglycemia.1 Risks of hypoglycemia.1 Importance of patients and responsible family members understanding symptoms and treatment of hypoglycemic reactions and identifying conditions that predispose to the development of such reactions.1
-
Importance of regular monitoring of blood glucose (preferably self-monitoring) and of HbA1c.1
-
Discuss potential for alterations in dosage requirements in special situations (e.g., illness, fever, trauma, infection, surgery); importance of informing clinician promptly if such situations occur.1
-
Importance of understanding primary and secondary failure to therapy.1
-
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1
-
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as any concomitant illnesses (e.g., type 1 diabetes mellitus, kidney or liver disease).1
-
Advise patients receiving β-adrenergic blocking agents about potential risk for hypoglycemia.1
-
Importance of informing patients of other important precautionary information.1 (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes |
Dosage Forms |
Strengths |
Brand Names |
Manufacturer |
---|---|---|---|---|
Oral |
Tablets, scored |
1 mg* |
Amaryl (scored) |
Sanofi-Aventis |
Glimepiride Tablets |
||||
2 mg* |
Amaryl (scored) |
Sanofi-Aventis |
||
Glimepiride Tablets |
||||
4 mg* |
Amaryl (scored) |
Sanofi-Aventis |
||
Glimepiride Tablets |
||||
6 mg* |
Glimepiride Tablets |
|||
8 mg* |
Glimepiride Tablets |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes |
Dosage Forms |
Strengths |
Brand Names |
Manufacturer |
---|---|---|---|---|
Oral |
Tablets |
2 mg with Pioglitazone Hydrochloride 30 mg (of pioglitazone)* |
Duetact |
Takeda |
Glimepiride with Pioglitazone Hydrochloride |
||||
4 mg with Pioglitazone Hydrochloride 30 mg (of pioglitazone)* |
Duetact |
Takeda |
||
Glimepiride with Pioglitazone Hydrochloride |
AHFS DI Essentials™. © Copyright 2024, Selected Revisions June 21, 2021. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
References
1. SanofiAventis Pharmaceuticals. Amaryl (glimepiride) tablets 1, 2, and 4 mg prescribing information. Bridgewater, NJ; 2009 Jul.
2. Anon. Glimepiride. Drug Future. 1992; 17:774-8.
3. Sato J, Ohsawa I, Oshida Y et al. Comparison between effects of glimepiride and glibenclamide on in vivo insulin action. Intl Congress Series. 1994; 1057:341-4.
4. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979; 28:1039-57. http://www.ncbi.nlm.nih.gov/pubmed/510803?dopt=AbstractPlus
5. Draeger E. Clinical profile of glimepiride. Diabetes Res Clin Pract. 1995; 28(Suppl):S139-46. http://www.ncbi.nlm.nih.gov/pubmed/8529506?dopt=AbstractPlus
6. Hatziagelaki E, Diamantopoulos E, Halvatsiotis P et al. The effect of a new sulfonylurea glimepiride (HOE 490) on the blood glucose control of type II diabetics. Diabetes Res Clin Pract. 1988; 5(Suppl 1):S481. http://www.ncbi.nlm.nih.gov/pubmed/2901329?dopt=AbstractPlus
7. Ladik T, Lotz N, Rupp P et al. Efficiency of the new sulfonylurea glimepiride in the treatment of type 2 diabetes. Diabetes Res Clin Pract. 1988; 5(Suppl 1):S487.
8. Hoechst Marion Roussel, Inc, Somerville, NJ: Personal communication.
9. Jackson JE, Bressler R. Clinical pharmacology of sulphonylurea hypoglycaemic agents: part 1. Drugs. 1981; 22:211-45. http://www.ncbi.nlm.nih.gov/pubmed/7021124?dopt=AbstractPlus
10. Defronzo RA, Ferrannini E, Koivisto V. New concepts in the pathogenesis and treatment of noninsulin-dependent diabetes mellitus. Am J Med. 1983; 74(Suppl 1A):52-81. http://www.ncbi.nlm.nih.gov/pubmed/6337486?dopt=AbstractPlus
11. Krentz AJ, Ferner RE, Bailey CJ. Comparative tolerability profiles of oral antidiabetic agents. Drug Safety. 1994; 11:223-41. http://www.ncbi.nlm.nih.gov/pubmed/7848543?dopt=AbstractPlus
12. Scientific Advisory Panel of the Executive Committee, American Diabetes Association. Policy statement: the UGDP controversy. Diabetes. 1979; 28:168-70.
13. Kerr CP. Improving outcomes in diabetes: a review of the outpatient care of NIDDM patients. J Fam Pract. 1995; 40:63-75. http://www.ncbi.nlm.nih.gov/pubmed/7807040?dopt=AbstractPlus
14. Anon. Glibenclamide: a review. Drugs. 1971; 1:116-40. http://www.ncbi.nlm.nih.gov/pubmed/5004340?dopt=AbstractPlus
15. Anon. Diabetes mellitus. NIH Cons Dev Conf Statement. 1986; 6:1-7.
16. Blake GH. Control of type II diabetes: reaping the rewards of exercise and weight loss. Postgrad Med. 1992; 92:129-32. http://www.ncbi.nlm.nih.gov/pubmed/1437899?dopt=AbstractPlus
17. United Kingdom prospective diabetes study group. United Kingdom prospective diabetes study (UKPDS) 16: overview of 6 years’ therapy of type II diabetes: a progressive disease. Diabetes. 1995; 44:1240-58.
18. Expert Committee of the Canadian Diabetes Advisory Board. Clinical practice guidelines for treatment of diabetes mellitus. CMAJ. 1992; 147:697-712. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1336391&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/1521215?dopt=AbstractPlus
19. Zimmerman B, Espenshade J, Fujimoto W et al. The pharmacological treatment of hyperglycemia in NIDDM. Diabetes Care. 1995; 18:1510-18. http://www.ncbi.nlm.nih.gov/pubmed/8722084?dopt=AbstractPlus
20. Tsumura K. Clinical evaluation of glimepiride (HOE490) in NIDDM, including a double blind comparative study versus gliclazide. Diabetes Res Clin Pract. 1995; 28(Suppl):S147-9. http://www.ncbi.nlm.nih.gov/pubmed/8529507?dopt=AbstractPlus
21. American Diabetes Association. Office guide to diagnosis and classification of diabetes mellitus and other categories of glucose intolerance. Diabetes Care. 1995; 18(Suppl 1):4.
22. Williams G. Management of non-insulin-dependent diabetes mellitus. Lancet. 1994; 343:95-100. http://www.ncbi.nlm.nih.gov/pubmed/7903785?dopt=AbstractPlus
23. Genuth S. Exogenous insulin administration and cardiovascular risk in non-insulin-dependent and insulin-dependent diabetes mellitus. Ann Intern Med. 1996;124(1 Part 2):104-9.
24. Henry R R. Glucose control and insulin resistance in non-insulin-dependent diabetes mellitus. Ann Intern Med. 1996; 124:97-103. http://www.ncbi.nlm.nih.gov/pubmed/8554221?dopt=AbstractPlus
25. DeFronzo RA. The triumvirate: β-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes. 1988; 37:667-87. http://www.ncbi.nlm.nih.gov/pubmed/3289989?dopt=AbstractPlus
26. Polonsky KS, Sturis J, Bell GI. Non-insulin-dependent diabetes mellitus—a genetically programmed failure of the beta cell to compensate for insulin resistance. N Engl J Med. 1996; 334:777-83. http://www.ncbi.nlm.nih.gov/pubmed/8592553?dopt=AbstractPlus
27. Swislocki A. Insulin resistance and hypertension. Am J Med Sci. 1990; 300:104-15. http://www.ncbi.nlm.nih.gov/pubmed/2206054?dopt=AbstractPlus
28. Bailey C, Turner R. Metformin. N Engl J Med. 1996; 334:574-9. http://www.ncbi.nlm.nih.gov/pubmed/8569826?dopt=AbstractPlus
29. Bailey CJ. Biguanides and NIDDM. Diabetes Care. 1992; 15:755-72. http://www.ncbi.nlm.nih.gov/pubmed/1600835?dopt=AbstractPlus
30. Lebovitz HE. Stepwise and combination drug therapy for the treatment of NIDDM. Diabetes Care. 1994; 17:1542-4. http://www.ncbi.nlm.nih.gov/pubmed/7882832?dopt=AbstractPlus
31. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care. 2003; 26(Suppl 1):S33-50.
32. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993; 329:977-86. http://www.ncbi.nlm.nih.gov/pubmed/8366922?dopt=AbstractPlus
33. Zimmerman BR. Preventing long term complications: implications for combination therapy with acarbose. Drugs. 1992; 44:54-9. http://www.ncbi.nlm.nih.gov/pubmed/1280578?dopt=AbstractPlus
34. Klein R, Klein BEK, Moss SE et al. Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy. JAMA. 1988; 260:2864-71. http://www.ncbi.nlm.nih.gov/pubmed/3184351?dopt=AbstractPlus
35. Clark CM Jr. Where do we go from here? Ann Intern Med. 1996; 124(1 Part 2):184-6. Editorial.
37. Ohkubo Y, Kishikawa H, Araki E et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin- dependent diabetes mellitus; a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995; 28:103-17. http://www.ncbi.nlm.nih.gov/pubmed/7587918?dopt=AbstractPlus
38. Laakso M. Glycemic control and the risk for coronary heart disease in patients with non-insulin-dependent diabetes mellitus. The Finnish studies. Ann Intern Med. 1996;124(1 Part 2):127-30.
39. Howanitz PJ, Howanitz JH. Carbohydrates. In: Henry JB, ed. Todd-Sanford-Davidsohn clinical diagnosis and management by laboratory methods. 17th ed. Philadelphia: WB Saunders Company; 1984:165-179.
40. USP DI: drug information for the health care provider. Johnson KW, ed. 16th ed. Rockville, MD: The United States Pharmacopeial Convention, Inc; 1993; 1:287.
41. Asmal AC, Marble A. Oral hypoglycaemic agents: an update. Drugs. 1984; 28:62-78. http://www.ncbi.nlm.nih.gov/pubmed/6378583?dopt=AbstractPlus
42. The Upjohn Company. Micronase (glyburide) prescribing information. Kalamazoo, MI; 1988 May.
43. Hoechst-Roussel Pharmaceuticals Inc. Diabeta (glyburide) prescribing information. Somerville, NJ; 1987 Dec.
44. Lebovitz HE. Clinical utility of oral hypoglycemic agents in the management of patients with noninsulin-dependent diabetes mellitus. Am J Med. 1983; 75(Suppl 5B):94-9. http://www.ncbi.nlm.nih.gov/pubmed/6369972?dopt=AbstractPlus
45. Koda-Kimble MA, Carlisle BA. Diabetes mellitus. In: Young LY, Koda-Kimble MA, eds. Applied therapeutics: the clinical use of drugs. 6th ed. Vancouver, WA: Applied Therapeutics, Inc; 1995: 48.1-48.62.
46. Raskin P. Combination therapy in NIDDM N Engl J Med. 1992; 327:1453-4. Editorial.
47. Yki-Järvinen H, Kauppila M, Kajanssu E et al. Comparison of insulin regimens in patients with non-insulin-dependent diabetes mellitus. N Engl J Med. 1992; 327:1426- 33. http://www.ncbi.nlm.nih.gov/pubmed/1406860?dopt=AbstractPlus
48. Pugh JA, Ramirez G, Wagner ML et al. Is combination sulfonylurea and insulin therapy useful in NIDDM patients? A metaanalysis. Diabetes Care. 1992; 15:953-9. http://www.ncbi.nlm.nih.gov/pubmed/1387073?dopt=AbstractPlus
49. Roerig. Glucotrol prescribing information. In: Huff BB, ed. Physicians’ desk reference. 43rd ed. Oradell, NJ: Medical Economics Company Inc; 1989:1782-3.
50. Fineberg SE, Schneider SH. Glipizide versus tolbutamide, an open trial: effects on insulin secretory patterns and glucose concentrations. Diabetologia. 1980; 18:49-54. http://www.ncbi.nlm.nih.gov/pubmed/6988265?dopt=AbstractPlus
51. Bristol-Myers Squibb Company. Glucophage (metformin hydrochloride) tablets and Glucophage XR (metformin hydrochloride) extended-release tablets prescribing information. Princeton, NJ; 2009 Jan.
52. Groop LC, Widén E, Ekstrand A et al. Morning or bedtime NPH insulin combined with sulfonylurea in treatment of NIDDM. Diabetes Care. 1992; 15:831-4. http://www.ncbi.nlm.nih.gov/pubmed/1516500?dopt=AbstractPlus
53. Hoechst-Marion-Roussel, Inc, Bridgewater, NJ: Personal communication.
54. Bloomgarden ZT. New and traditional treatment of glycemia in NIDDM. Diabetes Care. 1996; 19:295-9. http://www.ncbi.nlm.nih.gov/pubmed/8742586?dopt=AbstractPlus
55. Pratt Pharmaceuticals. Glucotrol (glipizide) tablets for oral use prescribing information. In: Physicians’ desk reference. 50th ed. Montvale, NJ: Medical Economics Company Inc; 1996:1967-8.
56. Bristol-Myers Squibb, Princeton, NJ: personal communication on metformin.
57. Turner R, Cull C, Holman R et al. United Kingdom Prospective Diabetes Study 17: a 9-year update of a randomized, controlled trial on the effect of improved metabolic control on complications in non-insulin-dependent diabetes mellitus. Ann Intern Med. 1996; 124(1 Pt 2):136-45. http://www.ncbi.nlm.nih.gov/pubmed/8554206?dopt=AbstractPlus
58. American Diabetes Association. Implications of the diabetes control and complications trial. Diabetes Care. 1996; 19:50-2S.
59. Turner RC, Cull CA, Frighi V et al. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirements for multiple therapies (UKPDS 49). JAMA. 1999; 281:2005-12. http://www.ncbi.nlm.nih.gov/pubmed/10359389?dopt=AbstractPlus
60. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998; 352:837-53. http://www.ncbi.nlm.nih.gov/pubmed/9742976?dopt=AbstractPlus
61. Nathan DM. Some answers, more controversy, from UKDS. Lancet. 1998; 352:832-3. http://www.ncbi.nlm.nih.gov/pubmed/9742972?dopt=AbstractPlus
62. American Diabetes Association. Implications of the United Kingdom Prospective Diabetes Study. Diabetes Care. 1999; 22(Suppl. 1):S27-31.
63. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998; 352:854-65. http://www.ncbi.nlm.nih.gov/pubmed/9742977?dopt=AbstractPlus
64. American Diabetes Association. The United Kingdom Prospective Diabetes Study (UKPDS) for type 2 diabetes: what you need to know about the results of a long-term study. Washington, DC; September 15, 1998. From American Diabetes Association web site. http://www.diabetes.org
65. Genuth P. United Kingdom prospective diabetes study results are in. J Fam Pract. 1998; 47:(Suppl.
66. Davis TM. United Kingdom Prospective Diabetes Study: the end of the beginning? Med J Aust. 1998; 169:511-2.
67. Matthews DR, Cull CA, Stratton RR et al. UKPDS 26: sulphonylurea failure in non-insulin-dependent diabetic patients over 6 years. Diabet Med. 1998; 15:297-303. http://www.ncbi.nlm.nih.gov/pubmed/9585394?dopt=AbstractPlus
68. Watkins PJ. UKPDS: a message of hope and a need for change. Diabet Med. 1998; 15:895-6. http://www.ncbi.nlm.nih.gov/pubmed/9827842?dopt=AbstractPlus
75. Bailey CJ, Nattrass M. Treatment—metformin. Baillieres Clin Endocrinol Metab. 1988; 2:455-76. http://www.ncbi.nlm.nih.gov/pubmed/3075902?dopt=AbstractPlus
76. Reaven GM, Johnston P, Hollenbeck CB et al. Combined metformin-sulfonylurea treatment of patients with noninsulin-dependent diabetes in fair to poor glycemic control. J Clin Endocrinol Metab. 1992; 74:1020-6. http://www.ncbi.nlm.nih.gov/pubmed/1569149?dopt=AbstractPlus
77. Gerich JE. Oral hypoglycemic agents. N Engl J Med. 1989; 321:1231-45. http://www.ncbi.nlm.nih.gov/pubmed/2677730?dopt=AbstractPlus
78. Anon. Metformin for noninsulin-dependent diabetes mellitus. Med Lett Drugs Ther. 1995; 37:41-2. http://www.ncbi.nlm.nih.gov/pubmed/7739421?dopt=AbstractPlus
79. Bristol-Myers Squibb, Princeton, NJ: personal communication.
80. Lim P, Khoo OT. Metformin compared to tolbutamide in thetreatment of maturity-onset diabetes mellitus. Med J Aust. 1970; 1:271-273. http://www.ncbi.nlm.nih.gov/pubmed/5440868?dopt=AbstractPlus
81. Fantus IG, Brosseau R. Mechanism of action of metformin:insulin receptor and postreceptor effects in vitro and in vivo. J Clin Endocrinol Metab. 1986; 63:898-905. http://www.ncbi.nlm.nih.gov/pubmed/3745404?dopt=AbstractPlus
82. Giugliano D, Quatraro A, Consoli G et al. Metformin forobese, insulin-treated diabetic patients: improvement in glycaemic control and reduction of metabolic risk factors. Eur J ClinPharmacol. 1993; 44:107-12.
83. Hermann LS, Melander A. Biguanides: basic aspects and clinical use. In: Alberti KGMM, DeFronzo RA, Keen H et al, eds. International textbook of diabetes mellitus. New York: John Wiley & Sons; 1992; 773-95.
84. DeFronzo RA, Goodman AM, and the Multicenter Metformin Study Group. Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. N Engl J Med. 1995; 333:541-49. http://www.ncbi.nlm.nih.gov/pubmed/7623902?dopt=AbstractPlus
85. Gregorio F, Ambrosi F, Marchetti P et al. Low dose metformin in the treatment of type II non-insulin-dependent diabetes: clinical and metabolic evaluations. Acta Diabetol Lat. 1990; 27:139-55. http://www.ncbi.nlm.nih.gov/pubmed/2198745?dopt=AbstractPlus
86. Hermann L. Biguanides and sulfonylureas as combination therapy in NIDDM. Diabetes Care. 1990; 13:37-41. http://www.ncbi.nlm.nih.gov/pubmed/2209342?dopt=AbstractPlus
87. Chiasson J, Josse R, Hunt J et al. The Efficacy of acarbose in the treatment of patients with non-insulin-dependent diabetes mellitus. Ann Intern Med. 1994; 121:929-935.
88. Reviewers’ comments on metformin (personal observations).
89. Hermann LS, Scherstén B, Bitzén PO et al. Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. Diabetes Care. 1994; 17:1100-9. http://www.ncbi.nlm.nih.gov/pubmed/7821128?dopt=AbstractPlus
90. Dunn CJ, Peters DH. Metformin: a review of its pharmacological properties and therapeutic use in non-insulin-dependent diabetes mellitus. Drugs. 1995; 49:721-49. http://www.ncbi.nlm.nih.gov/pubmed/7601013?dopt=AbstractPlus
91. Bristol-Myers Squibb Company. Glucophage (metformin hydrochloride) tablets prescribing information (dated 1999 Jan). In: Physicians’ desk reference. 53rd ed. Montvale, NJ: Medical Economics Company Inc; 1999 (Suppl A):A118-23.
92. Bristol-Myers Squibb Company. Executive summary (product information) on Glucophage (metformin hydrochloride). Princeton, NJ; 1995 Mar.
93. American Diabetes Association. Type 2 diabetes in children and adolescents. Pediatrics. 2000; 105:671-80. http://www.ncbi.nlm.nih.gov/pubmed/10699131?dopt=AbstractPlus
94. United Kingdom Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998; 317:703-13. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=28659&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/9732337?dopt=AbstractPlus
95. UK Prospective Diabetes Study (UKPDS) Group. Efficacy of atenolol and captopril in reducing risk of macrovascular complications in type 2 diabetes mellitus: UKPDS 39. BMJ. 1998; 317:713-20. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=28660&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/9732338?dopt=AbstractPlus
96. USP DI: drug information for the health care professional. 20th ed. Englewood, CO: Micromedex, Inc; 2000;1:306.
97. Chow CC, Sorensen JP, Tsang LWW et al. Comparison of insulin with or without continuation of oral hypoglycemic agents in the treatment of secondary failure in NIDDM patients. Diabetes Care. 1995; 18:307-14. http://www.ncbi.nlm.nih.gov/pubmed/7555472?dopt=AbstractPlus
98. Koda-Kimble MA. Diabetes mellitus. In: Koda-Kimble MA, Young LY, eds. Applied therapeutics: the clinical use of drugs. 5th ed. Vancouver, WA: Applied Therapeutics, Inc.; 1992:72–1-53.
99. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA. 2002; 287:2563-9. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2622728&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/12020338?dopt=AbstractPlus
100. Takeda Pharmaceuticals America. Actos (pioglitazone hydrochloride) tablets prescribing information. Deerfield, IL; 2009 Jan.
101. GlaxoSmithKline. Avandia (rosiglitazone maleate) tablets prescribing information. Research Triangle Park, NC; 2011 May.
102. Kipnes MS, Krosnick a, Rendell MS et al. Pioglitazone hydrochloride in combination with sulfonylurea therapy improves glycemic control in patients with type 2 diabetes mellitus: a randomized, placebo-controlled study. Am J Med. 2001; 111:10-7. http://www.ncbi.nlm.nih.gov/pubmed/11448655?dopt=AbstractPlus
103. Wolffenbuttel BHR, Gomist R, Squatrito S et al. Addition of low-dose rosiglitazone to sulphonylurea therapy improves glycaemic control in type 2 diabetic patients. Diabet Med. 2000; 17:40-7. http://www.ncbi.nlm.nih.gov/pubmed/10691158?dopt=AbstractPlus
104. Chiasson J, Josse R, Hunt J et al. The efficacy of acarbose in the treatment of patients with non-insulin-dependent diabetes mellitus. Ann Intern Med. 1994; 121:929-935.
105. Coniff RF, Shapiro JA, Seaton TB et al. Multicenter, placebo-controlled trial comparing acarbose (BAY g 5421) with placebo, tolbutamide, and tolbutamide-plus-acarbose in non-insulin-dependent diabetes mellitus. Am J Med. 1995; 98:443-51. http://www.ncbi.nlm.nih.gov/pubmed/7733122?dopt=AbstractPlus
106. Calle-Pascual AL, Garcia-Honduvilla J, Martin-Alvarez PJ et al. Comparison between acarbose, metformin, and insulin treatment in type 2 diabetic patients with secondary failure to sulfonylurea treatment. Diabetes Metab. 1995; 21:256-60.
107. Bristol-Myers-Squibb Company. Glucovance(glyburide and metformin hydrochloride) tablets prescribing information. Princeton, NJ; 2010 May.
108. Moses R, Carter J, Slobodniuk R et al. Effect of repaglinide addition to metformin monotherapy on glycemic control in patients with type 2 diabetes. Diabetes Care. 1999; 22:119-24. http://www.ncbi.nlm.nih.gov/pubmed/10333912?dopt=AbstractPlus
109. Fonseca V,, Rosenstock J, Patwardhan R et al. Effect of metformin and rosiglitazone combination therapy in patients with type 2 diabetes mellitus: a randomized controlled trial. JAMA. 2000; 283:1695-702. http://www.ncbi.nlm.nih.gov/pubmed/10755495?dopt=AbstractPlus
110. Bayer. Precose (acarbose) tablets prescribing information. West Haven, CT; 2003 Mar.
111. Mahmoud R. Dear healthcare professional letter: Important safety alert regarding medication errors. Titusville, NJ: Janssen Pharmaceutica, Inc; 2004 Oct 15.
112. Mahmoud R. Dear pharmacist letter: Important safety alert regarding medication errors. Titusville, NJ: Janssen Pharmaceutica, Inc; 2004 Oct 19.
113. Ortho-McNeil Neurologics. Reminyl renamed Razadyne in U.S. to support patient safety. Titusville, NJ; 2005 Apr 11. Press release.
115. American Diabetes Association. Preconception care of women with diabetes. Diabetes Care. 2004; 27(Suppl 1):S76-78.
117. Takeda Pharmaceuticals. Duetact (pioglitazone hydrochloride and glimepiride) prescribing information. Deerfield, IL; 2011 Jul.
118. Nathan DM, Buse JB, Davidson MB et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2006; 29:1963-72. http://www.ncbi.nlm.nih.gov/pubmed/16873813?dopt=AbstractPlus
119. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2003 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2003; 27(Suppl 2):S1-152.
122. Klein S, Allison DB, Heymsfield SB et al. Waist circumference and cardiometabolic risk: a consensus statement from shaping America's health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Diabetes Care. 2007; 30:1647-52. http://www.ncbi.nlm.nih.gov/pubmed/17360974?dopt=AbstractPlus
123. American Diabetes Association. Summary of revisions for the 2009 clinical practice recommendations. Diabetes Care. 2009; 32:S3-S5. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2613585&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/19118287?dopt=AbstractPlus
124. Dluhy RG, McMahon GT. Intensive glycemic control in the ACCORD and ADVANCE trials. N Engl J Med. 2008; 358:2630-33. Editorial. http://www.ncbi.nlm.nih.gov/pubmed/18539918?dopt=AbstractPlus
125. Stratton IM, Adler AI, Neil HA et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000; 321:405-12. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=27454&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/10938048?dopt=AbstractPlus
126. Bretzel RG, Voit K, Schatz H et al. The United Kingdom Prospective Diabetes Study (UKPDS): implications for the pharmacotherapy of type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes. 1998; 106:369-72. http://www.ncbi.nlm.nih.gov/pubmed/9831300?dopt=AbstractPlus
127. Skyler JS, Bergenstal R, Bonow RO et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. Diabetes Care. 2009; 32:187-92. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2606812&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/19092168?dopt=AbstractPlus
128. , Patel A, MacMahon S et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008; 358:2560-72. http://www.ncbi.nlm.nih.gov/pubmed/18539916?dopt=AbstractPlus
129. Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008; 358:2545-59. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=4551392&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/18539917?dopt=AbstractPlus
130. Duckworth W, Abraira C, Moritz T et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009; 360:129-39. http://www.ncbi.nlm.nih.gov/pubmed/19092145?dopt=AbstractPlus
131. American Diabetes Association. Aspirin therapy in diabetes: position statement. Diabetes Care. 2001; 24(Suppl.1):S62-3. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2663516&blobtype=pdf
132. Weiss IA, Valiquette G, Schwarcz MD. Impact of glycemic treatment choices on cardiovascular complications in type 2 diabetes. Cardiol Rev. 2009; 17(4):165-75. http://www.ncbi.nlm.nih.gov/pubmed/19525678?dopt=AbstractPlus
133. Holman RR, Paul SK, Bethel MA et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008; 359:1577-89. http://www.ncbi.nlm.nih.gov/pubmed/18784090?dopt=AbstractPlus
134. Nathan DM, Cleary PA, Backlund JY et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005; 353:2643-53. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2637991&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/16371630?dopt=AbstractPlus
135. Skyler JS. Non-insulin-dependent diabetes mellitus: a clinical strategy. Diabetes Care. 1984; 7(Suppl 1):118-29. http://www.ncbi.nlm.nih.gov/pubmed/6376024?dopt=AbstractPlus
136. Ismail-Beigi F, Moghissi ES. Glycemia management and cardiovascular risk in type 2 diabetes: an evolving perspective. Endocr Pract. 2008 Jul-Aug; 14:639-43.
137. US Food and Drug Administration. FDA significantly restricts access to the diabetes drug Avandia. Rockville, MD; 2010 Sep 23. News release from FDA web site. Accessed 2010 Nov 15. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm226975
138. Woodcock J (US Food and Drug Administration). Decision on continued marketing of rosiglitazone (Avandia, Avandamet, Avandaryl). Rockville, MD; Available at FDA website. Accessed 2010 Nov 15. http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM226959.pdf
139. Food and Drug Administration. FDA drug safety communication: Updated risk evaluation and mitigation strategy (REMS) to restrict access to rosiglitazone-containing medicines including Avandia, Avandamet, and Avandaryl. Rockville, MD; 2011 May 18. Available from FDA website. Accessed 2011 Jun 20. http://www.fda.gov/Drugs/DrugSafety/ucm255005.htm
140. Avandia (rosiglitazone maleate), Avandamet (rosiglitazone maleate and metformin hydrochloride), and Avandaryl (rosiglitazone maleate and glimepiride) tablets risk evaluation and mitigation strategy (REMS). Available from FDA web site. Accessed 2011 Aug 25. http://www.fda.gov/downloads/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm255624.pdf
141. Food and Drug Administration. FDA advisory committee meeting briefing document for NDA 21071 Avandia (rosiglitazone maleate). Rockville, MD; July 13 and 14, 2010. From FDA website. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/EndocrinologicandMetabolicDrugsAdvisoryCommittee/UCM218493.pdf
142. Lipska KJ, Ross JS. Switching from rosiglitazone: thinking outside the class. JAMA. 2011; 305:820-1. http://www.ncbi.nlm.nih.gov/pubmed/21304068?dopt=AbstractPlus
143. Niemi M, Backman JT, Neuvonen M et al. Effects of fluconazole and fluvoxamine on the pharmacokinetics and pharmacodynamics of glimepiride. Clin Pharmacol Ther. 2001; 69:194-200. http://www.ncbi.nlm.nih.gov/pubmed/11309547?dopt=AbstractPlus
144. Niemi M, Kivisto KT, Backman JT. Effect of rifampicin on the pharmacokinetics and pharmacodynamics of glimepiride. Br J Clin Pharmacol. 2000; 50:591-5. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2015006&blobtype=pdf http://www.ncbi.nlm.nih.gov/pubmed/11136298?dopt=AbstractPlus
698. Garber AJ, Handelsman Y, Grunberger G et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm 2020 executive summary. Endocr Pract. 2020; 26:107-139. http://www.ncbi.nlm.nih.gov/pubmed/32022600?dopt=AbstractPlus
699. Zelniker TA, Wiviott SD, Raz I et al. Comparison of the effects of glucagon-like peptide receptor agonists and sodium-glucose cotransporter 2 inhibitors for prevention of major adverse cardiovascular and renal outcomes in type 2 diabetes mellitus. Circulation. 2019; 139:2022-2031. http://www.ncbi.nlm.nih.gov/pubmed/30786725?dopt=AbstractPlus
704. American Diabetes Association. 9. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020; 43:S98-S110. http://www.ncbi.nlm.nih.gov/pubmed/31862752?dopt=AbstractPlus
705. American Diabetes Association. 10. Cardiovascular disease and risk management: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020; 43:S111-S134. http://www.ncbi.nlm.nih.gov/pubmed/31862753?dopt=AbstractPlus
706. American Diabetes Association. 11. Microvascular complications and foot care: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020; 43:S135-S151. http://www.ncbi.nlm.nih.gov/pubmed/31862754?dopt=AbstractPlus
More about glimepiride
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (71)
- Drug images
- Side effects
- Dosage information
- Patient tips
- During pregnancy
- Drug class: sulfonylureas
- Breastfeeding
- En español