Evaluating the safety of glimepiride for patients with Type 2 diabetes

This study evaluated the side effects in patients with type 2 diabetes (T2D) after treatment with glimepiride (Amaryl). The authors found that while glimepiride lowered mortality, the rate of most side effects was the same as other similar drugs.

Treatments for T2D aim to lower blood glucose levels. Sulphonylureas lower blood glucose levels by stimulating the production and release of a hormone called insulin. Insulin release then lowers blood glucose levels. Glimepiride is a type of sulphonylurea drug.

Recent studies have evaluated the safety of anti-diabetes medications for T2D. This includes how they influence the rate of heart attacks, stroke, low blood glucose levels, and other causes of mortality. The safety of glimepiride compared to other sulphonylurea drugs is under investigation.

Data from 26,509 patients with T2D that were prescribed sulphonylurea drugs were examined.  Of these, 5,944 patients received glimepiride and 20,565 received another type of sulphonylurea drug. The average follow-up period was 1.31 years.

Overall, glimepiride was associated with a similar occurrence of heart attacks and strokes as other sulphonylurea drugs. The occurrence of heart attacks was 8.3 per 1000 patients per year with glimepiride and 8.7 per 1000 patients per year with other sulphonylurea drugs. The occurrence of strokes was 7.8 per 1000 patients per year with glimepiride and 8.1 per 1000 patients per year with other sulphonylurea drugs.

Slightly more patients treated with glimepiride had episodes of low blood glucose levels compared to other sulphonylurea drugs. Low blood glucose levels occurred in 7.2 per 1000 patients per year with glimepiride and 5.9 per 1000 patients per year with other sulphonylurea drugs.

Glimepiride significantly reduced mortality by 23% compared to other sulphonylurea drugs. The average mortality rate was 27.8 per 1000 patients per year with glimepiride and 37 per 1000 patients per year with other sulphonylurea drugs. The most common causes of mortality were heart disease (38%), cancer (30%), and lung disease (13%). Glimepiride slightly lowered mortality risk due to heart disease by 17% compared to other sulphonylurea drugs.

The authors concluded that glimepiride reduced mortality risk compared to other sulphonylurea drugs. Glimepiride had a similar rate of side effects, including heart attacks and low blood glucose levels.

This study used previous (retrospective) data, which may limit these results. The follow-up period was also short.