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Glimepirid

Glimepirid

Description

An important antidiabetic drug comes in the fixed amount: After years ago, a large study (DDCT) in type 1 diabetics showed the importance of a good diabetes setting with standard blood sugar levels, for the type 2 diabetics by the UKPDS (United Kingdom Prospective Diabetes Study) also known to be occupied. The most important result - normal blood sugar and HbA1c values ​​are worthwhile! - was supplemented by other important findings.

Thus it could be shown that - assuming a good diabetes setting - the therapy with oral antidiabetics has to be the initial treatment of choice and that for the most important oral antidiabetics - such as sulfonylureas, metformin and acarbose - there are no serious side effects. In particular, it should be noted that the suspicion expressed on the basis of obsolete previous studies (UGDP) that sulfonylureas, but also biguanides, may cause cardiovascular damage, could not be confirmed at all.

For the particularly important type 2 diabetes tablet therapy, non-insulinotropic and insulinotropic substances are considered. Metformin, the glitazones and, to a certain extent, acarbose also counteract insulin resistance, while the insulinotropic substances focus on the glinides and, above all, the sulfonylureas, which have been used for decades.

It is believed that this characteristic high exchange rate of glimepiride is responsible for the pronounced effect on glucose sensitivity and protects the B cell from loss of responsiveness and premature fatigue. The focus is therefore on the physiologically adapted insulin secretion and the associated safety of the therapy. Glimepiride is the first drug ever that can be successfully administered at a single dose of one to three (four) milligrams in the morning.

Side effects

Thrombocytopenia , leukopenia , granulocytopenia , agranulocytosis , erythropenia, hemolytic anemia and pancytopenia Leukocytoclastic vasculitis , mild hypersensitivity reaction , which can develop into severe reactions with dyspnoea , blood pressure drop and sometimes shock . Hypersensitivity reaction is in the skin like pruritus , rash, urticaria and light hypersensitivity

Dosage

The starting point for successful treatment of diabetes is appropriate diet, regular physical activity as well as regular blood and urine controls. Tablets or insulin can not compensate if the patient does not follow the recommended diet. Dose is determined by the results of blood and urine glucose measurements.

The starting dose is 1 mg glimepiride per day. If good values ​​are achieved, this dose should be used as maintenance. For different dosage regimes, appropriate strengths are available. If control values ​​are not satisfactory, the dose should be incrementally increased, based on the glycemic control, with an interval of approximately 1 to 2 weeks between each step, to 2, 3 or 4 mg glimepiride per day. A dose of more than 4 mg glimepiride per day results in better results only in exceptional cases. The maximum recommended dose is 6 mg glimepiride per day.

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