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Physicians prescribe glimepiride and pioglitazone for blood glucose control in patients diagnosed with non-insulin dependent diabetes mellitus (NIDDM), commonly called diabetes 2. Though both medications perform similar actions, they belong to two different classifications of drugs. Health care providers might prescribe glimepiride and pioglitazone with other oral anti-diabetic medications for an enhanced glucose-reducing effect. Studies suggest that patients who take oral anti-diabetic medications have an increased risk of cardiovascular disease.
Glimepiride is categorized as a sulfonylurea medication and is often prescribed as the initial treatment for diabetes 2. When patients do not experience sufficient blood sugar control using glimepiride alone, physicians often prescribe metformin in addition. Pharmaceutical companies also combine sulfonylureas and metformin into one formulation. The benefits of glimepiride include the reduction of circulating blood sugar, as the medication stimulates pancreatic beta cells to release insulin. Glimepiride and pioglitazone also increase tissue sensitivity to insulin, decreasing insulin resistance.
Pioglitazone is a thiazolidinedione medication that increases the insulin sensitivity of cells in fatty tissue, the liver, and muscle tissue, decreasing the levels of unused circulating insulin in the bloodstream. The oral anti-diabetic also inhibits sugar release from the liver. Pioglitazone stimulates cellular receptor sites, which causes a chemical reaction that alters the transference of genetic material in genes that manage glucose and lipid control. Besides regulating blood sugar, the benefits of pioglitazone also include lowered triglycerides and increased high density lipoproteins (HDL).
Patients usually take one dose of either medication in the morning. Both glimepiride and pioglitazone may be taken with or without food. Both medications may cause adverse reactions, but side effects associated with pioglitazone are generally more severe. Diabetics taking glimepiride might experience dizziness, headaches, nausea, and generalized weakness, and individuals with allergies to sulfa medications may develop a reaction to glimepiride. Combining the medication with other antidiabetic agents increases the risk of hypoglycemia.
Side effects associated with pioglitazone include cold or flu-like symptoms, headaches, and muscle pain. Patients who take it might also experience weight gain caused by an increase in fatty tissue or generalized edema. Pioglitazone is not recommended for patients with advanced heart failure, and the drug may exacerbate symptoms of mild to moderate cardiac disease. A small number of patients also develop macular edema, which is fluid accumulation behind the eye.
Research indicates that patients using pioglitazone may experience a slight decrease in red blood cell counts. Women who take the drug have a slightly increased risk of suffering bone fractures. Moreover, pioglitazone interferes with the action of oral contraceptives and has induced ovulation in premenopausal women.