RATIONALE BEHIND THE COMBINATION OF SULFONYLUREA AND METFORMIN IN DIABETES MELLITUS

The prevalence of diabetes in India has been growing by leaps and bounds. The statistics in this regard are quite alarming. It is obvious that in a country like India, the rising prevalence of diabetes with its complications is likely to produce severe constraints on health care budgets in future. This explosion of diabetes in India has been viewed with serious concern by the WHO and the International Diabetes Federation (IDF). The two principal defects in type 2 diabetes are insulin deficiency and insulin resistance. Therefore, combining an insulin-providing agent with an insulin sensitizing agent will augment the efficacy of current anti- hyperglycaemic agents. This is the rational for the development and marketing of sulfonylurea/metformin combination tablets. The ultimate or primary goal of therapy for type 2 diabetes is to prevent the mortality and morbidity related to the microvascular and macrovascular complications. Since these disorders are life long, reduction in the number of tablets and daily doses is a very important consideration from the patient point of view.  It is increasingly obvious that to achieve this on a global perspective will have to identify better and more effective treatment strategies to maintain tight glycaemic control.