Clinical Diabetes 2006;7(3):253-264.
제2형 당뇨병환자에서 Glibenclamide와 Metformin 고정 복합제와 병용투여의 효과비교
노태웅, 이보담, 이상훈, 남지선, 김익성, 한정우, 심성록, 박종숙, 김철식, 곽혜선, 하헌주, 안철우, 김경래
Comparison the Effects of Glibenclamide/Metformin Tablets with Coadministration of Glibenclamide & Metformin on Type 2 DM Patients
Tae Woong Noh, Bo Dam Lee, Sang Hoon Lee, Ji Sun Nam, Ik Sung Kim, Jung Woo Han, Sung Rok Sim, Jong Suk Park, Chul Sik Kim, Hae Sun Kwak, Hun Ju Ha, Chul Woo Ahn, Kyung Rae Kim
Postprandial glucose level should be well controlled in type 2 diabetes mellitus as far as morbidity and mortality is concerned. Recently developed glibenclamide/metformin tablet was evaluated on its efficacy on postprandial glycaemic control as well as its relation with oxidative stress compared with glibenclamide coadministered with metformin separately. The aim of this study is to provide a pharmacologic therapy meeting the means for reducing the risk for micro- and macrovascular complication. Methods: In this multi-center, open-label, double-blind, cross-over trial, 40 patients were randomly classified into two groups: group 1 in which patients received glibenclamide /metformin 2.5/500 mg; group 2 in which patients received glibenclamide 2.5 mg coadministered with metformin 500 mg separately for 2 weeks. After 2 weeks of 1st treatment, they received another 2 weeks of 2nd treatment where two groups were crossed over and administered study medications in different way. Clinical characteristics, biochemical tests as well as oxidative stress were evaluated. Results: Statistically significant reduction in postprandial glucose (PPG) was observed in patients with glibenclamide/metformin tablets (51.2 vs. 27.9 mg/dL, P < 0.05). Also, malondialdehyde (MDA), products related to reactive oxygen species (ROS), significantly decreased in patients treated with combination tablets (2.86 vs. 1.74 uM, P < 0.01). Conclusion: In type 2 diabetic patients, glibenclamide/metformin tablets may provide better glycaemic control with significant reduction in PPG compared with coadministration of glibenclamide with metformin respectively. Combination tablets with improved glycemic control have closer relation with reduced ROS, a known-risk factor for cardiovascular complications. Improved glycaemic control with reducing ROS may slow down the occurrence and development of macrovascular complications in type 2 diabetic patients, therefore it may bring cost-effectiveness in the long-term care.
Key Words: Coadministration, Glibenclamide, Metformin, Oxidative stress, Postprandial glucose, ROS
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