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Review
. 2025 May-Jun;29(3):260-267.
doi: 10.4103/ijem.ijem_372_24. Epub 2025 Jun 28.

Efficacy and Safety of Gliclazide versus Glimepiride in T2DM Patients: A Systematic Review

Rifika Bansal  1 , Ravi Kant  1 , Yogesh Bahurupi  2 , Ashwarya Gupta  1
Affiliations
Review

Efficacy and Safety of Gliclazide versus Glimepiride in T2DM Patients: A Systematic Review

Rifika Bansal et al. Indian J Endocrinol Metab. 2025 May-Jun.

Abstract

This systematic review compares the efficacy and safety of gliclazide and glimepiride in managing type 2 diabetes mellitus (T2DM). A comprehensive search was conducted in multiple databases, including PubMed and Cochrane Library, to identify relevant randomised controlled trials and observational studies. Five studies were included based on pre-defined eligibility criteria, focussing on glycaemic control (HbA1c, fasting blood glucose, and post-prandial blood glucose) and safety outcomes like hypoglycaemia and cardiovascular events. Data were extracted and synthesised using established systematic review methodologies, and risk of bias was assessed with Cochrane tools. Both gliclazide and glimepiride effectively reduced HbA1c, but gliclazide showed a lower risk of hypoglycaemia. However, elderly patients using gliclazide had an increased risk of severe hypoglycaemia and fractures. This review indicates that while both drugs are effective, gliclazide may have a safer profile in middle-aged adults, with glimepiride potentially being a better option for older adults.

Keywords: Gliclazide; glimepiride; glycaemic control; hypoglycaemia; type 2 diabetes mellitus (T2DM).

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Study flow diagram
Figure 2
Figure 2
Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies
Figure 3
Figure 3
Risk of bias summary: review authors’ judgements about each risk of bias item for each included study
See this image and copyright information in PMC

References

    1. Chan SP, Colagiuri S. Systematic review and meta-analysis of the efficacy and hypoglycemic safety of gliclazide versus other insulinotropic agents. Diabetes Res Clin Pract. 2015;110:75–81. - PubMed
    1. Landman GWD, De Bock GH, Van Hateren KJJ, Van Dijk PR, Groenier KH, Gans ROB, et al. Safety and efficacy of gliclazide as treatment for type 2 diabetes: A systematic review and meta-analysis of randomized trials. PLoS One. 2014;9:e82880. - PMC - PubMed
    1. Dennis JM, Henley WE, Weedon MN, Lonergan M, Rodgers LR, Jones AG, et al. Sex and BMI alter the benefits and risks of sulfonylureas and thiazolidinediones in type 2 diabetes: A framework for evaluating stratification using routine clinical and individual trial data. Diabetes Care. 2018;41:1844–53. - PMC - PubMed
    1. Perl S, Cook W, Wei C, Ohman P, Hirshberg B. Effects of glimepiride versus saxagliptin on ?-cell function and hypoglycemia: A post hoc analysis in older patients with type 2 diabetes inadequately controlled with metformin. Clin Ther. 2016;38:2578–88. - PubMed
    1. Cho EH, Han K, Kim B, Lee DH. Gliclazide monotherapy increases risks of all-cause mortality and has similar risk of acute myocardial infarction and stroke with glimepiride monotherapy in Korean type 2 diabetes mellitus. Medicine (Baltimore) 2020;99:E21236. - PMC - PubMed

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