To compare compliance in type 2 diabetic patients treated with glimepiride once daily
or glibenclamide twice to three times daily.
Poorly controlled type 2 diabetic patients aged 35-65 years were randomized to glimepiride
1 mg once daily or to glibenclamide 1.25 mg twice daily. During initial titration,
doses ranged from 1 to 6 mg once daily (glimepiride) and from 1.25 mg twice daily
to 5 mg 3 times daily (glibenclamide) to achieve fasting blood glucose < 126 mg/dL.
The final titration phase doses were continued during the maintenance phase. Both
treatments were packed in electronic pill-boxes fitted with a microprocessor to record
dates and times of each opening. Compliance was assessed in terms of mean daily compliance
(MDC) and the ratio of days with adequate compliance (DAC). Glycemic control was assessed
in terms of the adjusted mean final HbA1c, and the incidence of hypoglycemia. Patient
satisfaction was evaluated using the Diabetes Treatment Satisfaction Questionnaire.
Compliance over the whole study was generally good, but the MDC was significantly
better with glimepiride (87+/-16%) than with glibenclamide (80+/-17%;P < 0.0001).
The ratios of DAC for glimepiride and glibenclamide were 87+/-16% and 67+/-24% respectively
(P < 0.0001). The adjusted final HbA1c, and the incidence of hypoglycemia were similar
in the two groups. Treatment satisfaction on the DTSQc was greater with glimepiride
than with glibenclamide (P = 0.0034).
Patient compliance and treatment satisfaction with once-daily glimepiride were significantly
better than with glibenclamide 2 to 3 times daily.