role of metformin & glilipiride in diabetes

ROLE OF METFORMIN AND GLIMIPIRIDEINDIABETES BY – ABHIJEET KUMAR

Diabetes Mellitus Metabolic disorder characterized by

chronic or persistant hyperglycemia. Associated with abnormal carbohydrate,

fat and protein metabolism. Major types a) Type 1 DM (IDDM) b) Type 2 DM (NIDDM) c) Gestational Diabetes

Type 1 DM must be managed by insulin injections.

Type 2 DM may be treated with medications with or without insulin.

Other treatment options Life style modification Diet and Exercise Pharmacological therapy

Diabetic Complications

Management of Type-2 DM Oral Hypoglycemic agents : Decreases glucose level by direct

stimulation on insulin secretion.Eg; Sulfonylurea derivatives1st Gen : Tolbutamide, Chlorpropamide.2nd Gen : Glibenclamide, Glipizide,

Gliclazide, Glimepride.

Anti-hyperglycemic agents :a) Sensitizers- improves insulin sensitivity. Eg; Bigunides - Metformin Glitazones – Rosiglitazone, Pioglitazoneb) Alpha-Glicosidase inhibitor- delaying glucose

absorption. Eg; Acarbose, Voglibose.c) DPP 4 enzyme inhibitor- extend the action of

insulin and supress glucagon release. Eg; Sitagliptin, Saxagliptin.

Metformin – Glimipiride Market The Rs 4,500 crore anti-diabetic market is

growing annually at 20%, with the glimepiride and metformin combination molecule contributing 1/4th of sales.

Widely-prescribed anti-diabetic drugs (glimepiride plus metformin) clocked sales of Rs 105 crore, in May 2014.

The anti-diabetic sub-class, a combination of glimepiride and metformin, registered a growth of 34.4% in May 2014.

Top leaders of Glimepiride Amaryl – Sanofi Zoryl – Intas Glimy – Dr.Reddys GP – USV Euglim – Zydus Glimulin – Glenmark Glypride – Sun

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Top leaders of Metformin Glyciphage – Franco Ind Glycomet – USV Obimet – Abbott Riomet – Ranbaxy Gliconorm – Lupin Xmet – Glenmark Cetapin XR – Aventis

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Various Combination available Metformin starting dose is 500mg b.i.d or

850mg o.d with meals and maximum dose is 2550mg per day.

Glimepiride 1mg + Metformin 500mg Glimepiride 2mg + Metformin 500mg Glimepiride 0.5 mg + Metformin 1000mgTriple drug combinations; (Glimepiride 1&2mg + Pioglitazone 15mg

+ Metformin HCl 500mg)

Top leaders Glycomet GP – USV Gemer – Sun Glimaday – Wokhardt Zoryl M – Intas Gluconorm G – Lupin

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End Note "While metformin is the best drug to treat

diabetes, combination therapy with glimepiride is required in most cases sooner or later. In India, this combination is most commonly-used since it is cheap and effective. Because of unabated diabetes increasing use of this combined therapy is understandable", says Dr Anoop Misra, director of Delhi-based Fortis-CDOC hospital for diabetes.