Influence of Glimepiride on Short-Term Weight Change in Overweight to Obese Diabetic Subjects

Sulfonylureas, antidiabetic agents that act on the pancreas to stimulate insulin secretion, are known to cause weight gain. Glimepiride, a new sulfonylurea, is supposed to have extrapancreatic effects, leading to less weight gain. We compared the effect of glimepiride on weight change, glycemic control, blood pressure, and lipid metabolism, to that of gliclazide, a conventional sulfonylurea. Twenty-four (M 16/F 8) overweight to obese (BMI 25.4±2.9) type 2 diabetic (FPG 192±30 mg/dl, IRI 11±7 μ U/ml, HbA1C 8.5±0.9%) subjects were divided into 2 groups, 1 taking glimepiride and the other gliclazide, and followed up for 4 months. The 0.4 kg weight gain in the glimepiride group (n = 13) was significantly lower than that in the gliclazide group (n = 11, p < 0.01). The degree of improvement in HbA1C, blood pressure, and lipid parameter did not differ between groups. Glimepiride was therefore at least superior to gliclazide regarding weight change in Japanese overweight to obese type 2 diabetics, although follow-up was relatively short.