Diabetes drug glimepiride (amaryl) lacks weight gain side effect

18 June 2002

New Australian research has shown that glimepiride, a sulfonylurea drug known by the brand name Amaryl in Australia, can improve blood glucose control without the weight gain commonly found with sulfonylurea drugs.

Glimepiride is a tablet used in Australia for the treatment of type 2 diabetes, also known as non-insulin dependent diabetes. It is one of a class of drugs called sulfonylureas which are used to increase insulin secretion from the pancreas to control blood sugar levels. Weight gain is a common side-effect of sulfonylurea therapy.

Dr Anthony Roberts, lead investigator of the research, from the Department of Endocrinology at the Royal Adelaide Hospital, said: ‘The findings are a major step forward for the estimated one million Australians with type 2 diabetes, particularly the estimated 300,000 receiving sulfonylureas to control their disease.’


Blood glucose control

Professor Lesley Campbell, Director of the Diabetes Centre at St Vincent’s Hospital in Sydney, claims sulfonylureas are often a double-edged sword for type 2 diabetes patients who are overweight.

This is because weight reduction is usually an important factor in the management of type 2 diabetes. Many overweight or obese people with type 2 diabetes would be able to control their type 2 diabetes without medication if they followed a healthy diet and exercised and lost weight. Putting on weight will only make blood glucose control more difficult.

‘A sulfonylurea that does not promote weight gain will offer significant benefit to type 2 diabetes patients with a high Body Mass Index (BMI),’ Professor Campbell said.

‘While these agents [sulphonylureas] are effective at reducing glycated haemoglobin (HbA1c), until now they have typically been associated with weight gain,’ she said.

Glycated haemoglobin (HbA1c) is a blood test that doctors use to measure how well controlled blood sugar has been over the preceding couple of months. A normal result for a person without diabetes would be between 4 and 6 per cent. For people with type 2 diabetes they often have to work hard on their diet and exercise and take medications to get their HbA1c down.

In the study, the average HbA1c was reduced from 8.54% at the beginning of the study to 7.86% in those who were followed up at 9 months. A total of 1607 patients out of an initial 3190 returned for at least one follow up visit.

According to Dr Roberts, ‘On average, patients taking this ‘smart sulfonylurea’ not only reduced their blood sugar levels, but lost weight. Regardless of the dose, the average weight loss was 1.3 kg, with obese patients tending to lose the most weight.

‘To a diabetes patient whose weight has been increasing and hindering their ability to control their disease, this is a truly significant finding as we are fighting a disease dubbed ‘diabesity’, where obesity and diabetes go hand-in-hand.’

Patients in the trial were either on glimeripiride alone or in combination with other agents such as metformin or insulin.


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