Three studies were performed to assess the efficacy of various sulphonylureas in the management of diet-failed
NIDDM patients. In the first study, 224 patients inadequately controlled by diet alone or with oral hypoglycaemics received
gliclazide in addition to diet or in place of existing drugs for three months. The dosage was adjusted to obtain adequate control or up to the maximum recommended dosage. Good glycaemic control was achieved in 65% of patients. Conversion from other oral hypoglycaemics to
gliclazide led to an improvement in control except in cases previously treated with
glibenclamide. In the second study, diabetic control was compared in 112
NIDDM patients treated concurrently for one year with
chlorpropamide,
glipizide,
gliquidone,
glibenclamide or
gliclazide. On the basis of
HbA1 levels, the best results were obtained with
glibenclamide and
gliclazide, leading to normal
HbA1 levels in 74% and 80% of patients, respectively. In the third study, secondary failure rates were assessed in 248
NIDDM patients treated for five years with
gliclazide,
glibenclamide or
glipizide.
Gliclazide had the lowest secondary failure rate (7%) and was significantly better than
glipizide (25.6% failures in five years), but the difference relative to
glibenclamide (17.9%) just failed to reach the threshold of significance. The results of these studies show that
gliclazide is a potent hypoglycaemic agent which compares favourably with others of its type. It has a low incidence of side effects, few problems with hypoglycaemia, and retains its efficacy longer than other sulphonylureas.
Gliclazide may therefore be considered a first choice for the
therapy of diet-failed
NIDDM patients.