Metformin plus low glimepiride doses, improve significantly HOMA(ir) and HOMA(beta cell) without hyperinsulinemia in patients with type 2 diabetes

Type 2 Diabetes mellitus is characterized by insulin resistance and defects in insulin secretion. These variables have been studied by the euglycemic/hyperinsulinemic clamp and MinMod, which difficult the HOMA(IR) and HOMA(beta cell) failure study in clinical practice. The aim of this study was to evaluate three different anti-diabetic therapeutic options using a mathematical model (Homeostasis model assessment, HOMA). Seventy type 2 diabetic patients were randomly assigned one of the next therapeutic options: A) Metformin + ADA Diet + Physical activity (Walk, 60 minutes/day). B) Metformin + Glimepiride + ADA Diet + Physical activity. C) Only ADA diet + Physical activity. A blood sample was taken before and after the treatment to determine basal and post-prandial blood glucose, basal insulin and HbA(1c) and to calculate HOMA(beta cell) and HOMAIR. Before treatment basal and post-prandial levels of glucose, HbA(1c), basal insulin and HOMA(IR) and HOMA(beta cell) were significantly different when compared to after treatment levels for each group (p<0.01). Significant differences were also found when comparing basal blood glucose reduction (51.8 %; p<0.01), post-prandial blood glucose (55.0%; p<0.05), and HOMA(IR) (65.3%; p<0.01) of group B (Metformin + low glimepiride dose) with the other therapeutic options. We conclude that metformin plus glimepiride at a low dose is a more effective treatment for type 2 diabetes than other therapeutic options. HOMA(IR) and HOMA(beta cell) are inexpensive and reliable methods to study HOMA(IR) and HOMA(beta cell) function in DM2.