Improving the Glimepiride Efficacy in Type 2 Diabetes Treatment: A Review of the Potential Advantages and Disadvantages of Glimepiride as Hypoglycemic Oral Medication

Abstract

Type 2diabetes(T2DM) is a major health problem that affects the majority of advanced and developing countries at the same limit, T2DM is a common metabolic disorder which caused by primary two factors :inability of pancreatic beta cells to secrete enough insulin to counteract hyperglycemia and insulin resistance due to dyslipidemia, obesity and low physical activity, also there are unmodifiable factors like genetic predisposition ,family history ,age, ethnicity and race . The major concern of T2DM is its microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular (cardiovascular, peripheral vascular, and cerebrovascular diseases) complications which act as a burden on health and economic organizations so finding proper, available and safe medications is a great concern to many countries to reduce the load on economic and health organizations. There are many oral drug classes introduced for treating T2DM,
one of them is sulphonylurea. The most commonly used drug of this class is glimepiride which is considered as the most effective and the safest one of sulphonylureas but it has some side effects like weight gain, hypoglycemia, and destruction of beta-cell after a short duration of reaching the maximal dose so many experimental and clinical trials are done to improve its safety profile. In this review, we provided a general view of experimental and clinical trials that were done to avoid glimepiride side effects through combination with other oral hypoglycemic drugs, drug supplements, and natural products. Additionally, clarification if natural products combination with glimepiride had better safety profile and efficacy rather than other drug categories.