Glimepiride stimulates insulin release from pancreatic beta cells. Metformin has the advantage of decreasing insulin resistance and can be used as first line therapy in combination with sulphonylurea.

Studies have shown that addition of metformin to sulphonylurea treated patients with inadequate glycemic control is associated with improved glycemic control, lower post prandial insulin and triglyceride concentration and improved dyslipidemia.

All these changes decreases the risk of coronary heart disease.

Type-2 diabetes

One tablet once daily.

Common adverse effects include dizziness, asthenia (generalized weakness), headache, nausea and hypoglycemia.

Gepride M is available as a strip of 10 tablets.

The primary mechanism of action of glimepiride in lowering blood glucose appears to be dependent on stimulating the release of insulin from functioning pancreatic beta cells.

In addition it also has an extra pancreatic activity. Besides releasing insulin, glimepiride by itself improves the sensitivity of the insulin receptor and thus improves blood glucose control. Glimepiride has certain valuable advantages over other sulphonylureas like; Glimepiride causes insulin release in the same phases as that of natural pattern of insulin release.

Thus, there is no continuous release of insulin, hence there are very less chances of hypoglycemia.

Type 2 diabetes (NIDDM)

One tablet once a day

Hypersensitivity to Glimepiride

The most common adverse effects noted were dizziness, headache, nausea.

Gepride is available as a strip of 10 tablets.

Glucozid is the most beneficial oral antidiabetic agent belonging to the class of sulfonylureas. Glucozid achieves better glucose control, has lower incidence of secondary failure rates, lesser hypoglycemic events and potential free radical scavenging activity.

NIDDM when dietary modification has failed

Treatment is started with a dose of 40-80 mg/day just before meal o.d, increasing by 40 or 80 mg every few days if necessary to a max. of 320 mg. More than 160 mg is given as b.i.d dose. The treatment should begin with low doses in patients with renal and/or hepatic impairment.

Insulin dependent diabetes mellitus, Pregnancy, Severe renal insufficiency, Hepatic impairment, Thyroid impairment.

Hypoglycemia, headache, gastrointestinal upsets, nausea and dizziness has been reported and skin reactions, including rash, pruritis, erythema may occur.

Glucozid is available as a strip of 10 tablets.

Two well known causes of diabetes are:

• Deficiency of Insulin secretion and
• Insulin resistance

Gliclazide in Glucozid-M increases insulin secretion from pancreatic beta cells, while Metformin increases insulin sensitivity by decreasing Insulin resistance. Glucozid-M has a synergistic effect in lowering fasting & postprandial glucose and glycosylated haemoglobin levels. Glucozid-M increases glycemic control in patients with suboptimal glycemic control.

Non Insulin Dependent Diabetes Mellitus.

Glucozid-M should be administered at a dose of 1-2 tablets once or twice daily with meals to a maximum of 4 tablets/day.

Hypoglycemia, nausea, abdominal discomfort, metallic taste, rash, pruritis etc.

Glucozid-M is available as a strip of 10 tablets.

Type 2 diabetes mellitus is a progressive disorder, and although oral dual therapy is often initially successful, it is associated with a secondary failure rate, which contributes to the development of long-term diabetes complications resulting from persistent hyperglycemia.

Later in the course of the disease, the use of combinations of three oral agents may delay the need for insulin while maintaining glycemic control, thus making aggressive oral treatment more acceptable for many patients.

Combination therapy using oral antidiabetic agents with different mechanisms of action can be highly effective in achieving and maintaining target blood glucose levels.

Type II diabetes mellitus uncontrolled by any dual drug therapy.

One tablet once daily.

Headache, flu like syndrome, nausea, sinusitis and rarely hypoglycemia may occur.

Known hypersensitivity to any of the components.

Trigem is available as a strip of 10 tablets.

It is an alpha-glucosidase inhibitor. It inhibits the conversion of disaccharides into monosaccharide like glucose (Absorbable form), thereby delaying the digestion and absorption of carbohydrates resulting in decreased postprandial hyperglycemia.

It is important to control postprandial hyperglycemia(PPHG) as it is strongly related to insulin resistance, higher blood pressure, obesity, and dyslipidemia.

• Non-insulin-dependent diabetes mellitus.
• In insulin dependent diabetes mellitus.
• Voglibose may also be used in combination with a sulfonylurea when diet plus either voglibose or a sulfonylurea alone do not result in adequate glycemic control.

Dosage must be individualized; not exceeding the maximum recommended dosage of 0.6mg 3 times daily. Voglibose should be taken three times daily at the start (with the first bite) of each main meal.

Gastrointestinal side effects like abdominal pain, diarrhea, and flatulence can occur.

Since voglibose is not metabolized and eliminated unchanged by the kidneys, it should not be used in renal failure.

Vogli is available as a strip of 10 tablets.

Postprandial hyperglycemia is an independent risk factor for macro vascular complications. However, the normalization of postprandial plasma glucose peaks in clinical practice is recognized as more problematic than the overall management of fasting plasma glucose levels.

The causes of PPHG are influenced by many factors which include a rapid flux of glucose from the gut, impaired insulin release, endogenous glucose production by the liver, peripheral insulin resistance.

Voglibose in Vogli M reduces postprandial hyperglycemia primarily by interfering with the carbohydrate digesting enzymes and delaying glucose absorption.

Metformin in Vogli M reduces Insulin Resistance, decreases glucose absorption & inhibits Gluconeogenesis.

Both drug acts on different parameters and gives additive effect in the management of Post Prandial Hyperglycemia and achieves A1C goal.

• Post Prandial Hyperglycemia
• Type 2 diabetes not controlled with diet/ monotherapy
• Obese Type-2-Diabetic Patients
• Impaired Glucose Tolerance (IGT)
• Adjuvant to Insulin therapy in Type-1 Diabetic.

1 tablet with each major meal.

Metallic taste, abdominal distension, Nausea, Vomiting, Diarrhoea.

Pregnancy, Liver disease, Kidney failure.

Vogli M is available as a strip of 10 tablets.