Efficacy of Some Combination Regimens of Oral Hypoglycaemic Agents in Type 2 Diabetes Mellitus Patients

Purpose: To examine the efficacy of selected oral hypoglycaemic agent (OHA) regimens in a small group of patients receiving such treatment.
Methods: This was a retrospective, observational study that involved patients who had been diagnosed with type 2 diabetes mellitus and undergoing routine follow-up at a teaching hospital. By reviewing patients’ medical records, changes in fasting blood glucose (FPG) and glycated haemoglobin (HbA1c) levels induced by several OHA cobmination regimens were documented. Target FPG and HbA1c were defined as 4.4 - 6.1 mmol/L and 6.5 %, respectively.
Results: Based on the medical records of 156 patients reviewed, the combination of metformin and gliclazide was the most commonly prescribed regimen (63.46 %). The use of gliclazide + rosiglitazone + acarbose produced the greatest reduction in FPG and HbA1c (-4.80 mmol/L and - 4.20 %, respectively), but the number of patients receiving this combination was too small to allow definitive conclusions to be made. More patients in the triple OHA group were able to achieve the desired glycaemic control than those in the dual OHA group (FPG, 44.44 % versus 41.18 %; HbA1c, 52.94 % versus 47.06 %), highlighting the important benefits conferred by the use of multiple OHAs.
Conclusion: The efficacy of various OHA combinations varies, and adding a third drug to a dual-agent regimen further reduces FPG and HbA1c levels. Though gliclazide + rosiglitazone + acarbose produces the greatest reduction in FPG and HbA1c levels, larger studies are required to confirm these findings.

Keywords
Type 2 diabetes mellitus; Oral hypoglycaemic agents; Fasting plasma glucose (FPG); Glycated haemoglobin (HbA1c); Combination therapy; Gliclazide; Rosiglitazone; Acarbose