Comparative Efficacy of Metformin and Sulfonylurea in Monotherapy or Combination for Type 2 Diabetes

Despite the extensive efforts of physicians to achieve better control and management for blood glucose level in type 2 diabetics, maintaining near normal blood glucose level in these patients remain unsatisfactory. The objective of the study was to compare the effectiveness of sulfonylureas, metformin and combination of metformin plus sulfonylureas in controlling blood glucose in type 2 diabetics. Retrospective cohort research design conducted during the period of two months from 1st November 2019 to 1st March 2020 at Northern Area Armed Forces Hospital in Hafr Al Batin- Saudi Arabia on sample of 217 diabetic patients’ files, all data coded with serial number and analyzed by SPSS program through and inferential and descriptive statistics. Mean decrease in HbA1c for metformin therapy was 1.5(%), for sulfonylurea was 1.4(%), for combination therapy was 1.9(%). Mean decrease in HbA1c fasting blood glucose for metformin therapy was 1.8(mmol/l), for sulfonylurea was 1.6(mmol/l), for combination therapy was 3(mmol/l). Mean decrease in postprandial blood glucose for metformin therapy was 3.2(mmol/l), for sulfonylurea therapy was 3(mmol/l), for combination therapy was 3.7(mmol/l). There was a significant difference between levels of HbA1c between metformin group and combination group (metformin and sulfonylurea) (p = 0.002) and also there was a significant difference between sulfonylurea group and combination group (metformin and sulfonylurea) in relation to HbA1c levels (p = 0.001). However, there was no significant difference between metformin and sulfonylurea in decreasing HbA1c (p = 0.09). In conclusion, metformin or sulfonylurea as a single therapy is similar in efficacy in reducing glycosylated hemoglobin level, fasting and post-prandial plasma glucose levels to equal degree. However, combination of both therapies resulted in significant greater control of blood glucose level.