Continual hyperglycaemia is a well-known risk factor in type-2 diabetics for the micro- and macrovascular complications. There are a variety of drugs available for the treatment of type-2 diabetes and no fixed regime possible, which fits all. Therefore choosing an appropriate anti-diabetic agent from the available groups is a tricky process for prescribers. To this purpose, we studied the nateglinide versus glimepiride monotherapy in type-2 diabetes patients in a tertiary care hospital.
Method- The present prospective study was conducted to compare the effect of glimepiride and nateglinide in all patients with type – 2 diabetes attending general medicine OPD for three months between March 2011 to May 2011 at tertiary care hospital, Puducherry. The total number of patients was 40, equally divided into two groups. Fasting blood sugar with 140 to 220 mg/dl were included, and patients with diabetic complications and hepatic and renal disorders were excluded from the study. Group I consists of 20 newly diagnosed type – 2 DM taking glimepiride 1 mg and group -2 consists of 20 newly diagnosed type – 2 DM taking Nateglinide monotherapy 60mg once daily laboratory parameters like FBS, PPBS, HbA1c and lipid profile and have been measured before and after study. The study continued for three months and every two weeks; FBS and PPBS were measured. Mean, SD, and percentages were used to describe the data. Chi-square and unpaired "t" test were used appropriately as inferential tools. P value <0.0.5 was considered statistically significant.
Results- The mean change in FBS was 18.55% with the treatment group taking glimepiride 1mg and the mean change in FBS with nateglinide group was 22.35%.The mean change in PPBS was 16.78% in treatment with glimepiride 1mg group, and the mean change in PPBS in nateglinide was 22%. Mean change in the glycosylated haemoglobin was 10.5% with the group taking glimepiride and was with patient taking nateglinide was 16.49%.
Conclusion- It was obvious that both glimepiride and nateglinide are effective, but the decrease in PPBS and HbA1c% was more with nateglinide. A further study in the large population is essential to assess long-term postprandial glucose control and relationship to diabetic complications.