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Effects and patient compliance of sustained-release versus immediate-release glipizides in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

Abstract
This review aimed to address effects of sustained-release versus immediate-release glipizide on glucose control, insulin secretion, and compliance. We searched Medline, EMBASE, the Cochrane Library, and Chinese Biomedical database from inceptions to May 31, 2011, screened reference lists of relevant studies, and contacted pharmaceutical companies. Randomized trials and cohort studies were included. We pooled data using a random-effect model. Nineteen trials involving a total of 1440 patients and 2 retrospective cohort studies with a total of 13452 patients were included. Trials were of low quality. No trials reported patient important outcomes. The reduction of fasting plasma glucose from the baseline appeared larger for sustained-release than for immediate-release glipizide (mean difference -0.26 mmol/L, 95% CI -0.52 to -0.01). The reduction was not significantly different between the two drugs for HbA1c (-0.03%, -0.20% to 0.14%) or 2-hour postprandial plasma glucose (-0.21 mmol/L, -0.96 to 0.55). Sustained-release glipizide appeared to reduce insulin secretion from the baseline, whereas the immediate-release formulation increased the secretion (fasting insulin: -1.04 vs. 0.88 μIU/ml; 2-hour postprandial insulin: -2.94 vs. 0.24 μIU/ml). Patients administering sustained-release glipizide had less hypoglycemia (Peto odds ratio 0.21, 95% CI 0.08 to 0.52) and lower missed dosing (Peto odds ratio 11. 42, 95% CI 6.47 to 20.18). The cohort studies showed patient compliance results consistent with those of the trials. Sustained-release glipizide appears to achieve similar glucose control with decreased insulin secretion, fewer hypoglycemic episodes, and higher patient compliance than immediate-release glipizide. However, these findings are inconclusive due to inadequate study quality, short follow up, and unavailability of patient important outcomes.
AuthorsLi Wang, Xin Sun, Liang Du, Qiang Yuan, Honghao Li, Haoming Tian, Youping Li
JournalJournal of evidence-based medicine (J Evid Based Med) Vol. 4 Issue 4 Pg. 232-41 (Nov 2011) ISSN: 1756-5391 [Electronic] England
PMID23672754 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
Copyright© 2011 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.
Chemical References
  • Blood Glucose
  • Delayed-Action Preparations
  • Hypoglycemic Agents
  • Glipizide
Topics
  • Blood Glucose (analysis)
  • Delayed-Action Preparations (therapeutic use)
  • Diabetes Mellitus, Type 2 (blood, drug therapy)
  • Glipizide (therapeutic use)
  • Humans
  • Hypoglycemic Agents (therapeutic use)
  • Medication Adherence (statistics & numerical data)

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