Oral
antidiabetic combination
therapy is a proven means of establishing glycaemic control in the hyperglycaemic, Type 2 diabetic patient, but co-administering two oral
antidiabetic agents separately may hinder compliance with
therapy. A new single-
tablet of
glyburide/metformin combination
therapy (
Glucovance), Bristol-Myers Squibb, Inc.) has recently been developed, which addresses the primary defects of
Type 2 diabetes: beta-cell dysfunction and
insulin resistance. The
glyburide/metformin tablet, taken with meals, is designed to optimise the absorption of
glyburide and to address the postprandial
glucose rise.
Glyburide/metformin tablets are more effective in controlling fasting and postprandial glycaemia than its component monotherapies, at lower doses of
metformin and
glyburide compared with monotherapy because of the synergy between its
glyburide and
metformin components. Moreover, a double-blind study showed that
glyburide/metformin tablets are more effective than a free combination of
glyburide co-administered with
metformin in controlling postprandial
glucose. Retrospective analyses suggested that
glyburide/metformin tablets control glycated haemoglobin (A1C) more effectively than a free combination of
glyburide co-administered with
metformin, at lower mean doses of
glyburide and
metformin. The incidence of side effects is lower than separate component
therapy for any given A1C.
Glyburide/metformin tablets are an effective option for optimising the control of
blood glucose in Type 2 diabetic patients and appear to enhance adherence to
therapy.