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

Ordain Presents

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

Ordain Presents

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

Ordain Presents

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.