RESUMO
To evaluate the safety and efficacy [glycemic control] provided by repaglinide compared with glibenclamide in newly diagnosed type 2 [non-insulin dependant] diabetic patients. Diabetic clinic in medical outdoor of Mayo Hospital, Lahore. Randomized prospective study. This single center study of one year duration was carried out in 100 patients between 30-70 years, all diagnosed to have type 2 diabetes mellitus recently and were not on any treatment. They were randomly categorized into two groups, repaglinide [test] and glibenclamide [control] groups. The study consisted of an initial induction day followed by follow-up visits after every fortnight. Repaglinide was given pre-prandial up to three times a day and glibenclamide was administered once or twice daily. Dosage was adjusted after every visit according to blood glucose level. Fasting blood glucose level, two hours postprandial blood glucose, weight and blood pressure were recorded on every visit, while glycosylated hemoglobin [HbA1c] was estimated thrice during the study [at the beginning, at six months and at the end of one year]. Of the hundred randomized patients [50 in each groups], all showed a decrease in fasting blood glucose level, two hours postprandial blood glucose and HbA1c. Mean reduction in fasting blood glucose in repaglinide group was 64+53 mg/dl and those by glibenclamide group was 34.7+53 [P=0.007]. The mean reduction in two hours postprandial blood glucose was 119+66 in repaglinide group, while 87.6+74 was observed in glibenclamide group [P=0.02].HbA1c mean reduction in both repaglinide and glibenclamide groups was 1.1+0.3 and 0.7+0.5 respectively [P=0.00]. No statistically significant weight change was observed and no hypoglycemic events were recorded in both the groups. The results suggest that repaglinide and glibenclamide both were effective in lowering fasting glucose level, two hours postparandial blood glucose level and HbA1c if used regularly for one year. The effect of repaglinide in lowering HbA1c was impressive as compared to glibenclamide. Both the drugs were well tolerated and weight change was minimal in both the groups