Glipizide combined with metformin versus metformin alone and hypoglycemic seizure: a retrospective cohort study

Abstract

OBJECTIVE

To identify the rates of hypoglycemic seizure after receiving glipizide combined with metformin versus metformin alone.

METHODS

We conducted a retrospective cohort study comparing the rate of hypoglycemic seizure in patients after glipizide combined with metformin versus metformin therapy. Patient medical records of those who admitted with hypoglycemia caused by either glipizide combined with metformin or metformin between January 2011 and August 2015 at Khon Kaen Hospital in Thailand. The primary outcome was the rate of hypoglycemic seizure in the patients with the two types of treatment. The secondary outcomes included confusion, lethargy, stupor, coma, metabolic acidosis, and death.

RESULTS

A total of 880 medical records were reviewed (166 in the glipizide combined with metformin group and 126 in the metformin group). There was no differences between the two groups in relation to rate of hypoglycemic seizure; 40 patients (24.1%) in glipizide combined with metformin group and 34 patients (27.0%) in the metformin group (adjusted odds ratio [AOR], 1.75; 95% confidence interval [CI], 0.75 to 4.11). There were also no different in rate of confusion (11.4% vs. 9.5%; AOR, 1.05; 95% CI, 0.36 to 3.01), lethargy (24.1% vs. 19.8%; AOR, 0.90; 95% CI, 0.39 to 2.10), stupor (6.6% vs. 4.0%; AOR, 3.05; 95% CI, 0.55 to 16.81), coma (30.7% vs. 25.4%; AOR, 1.41; 95% CI, 0.86 to 3.11), metabolic acidosis (3.6% vs. 5.6%; AOR, 0.42; 95% CI, 0.08 to 2.20). Two people died; one from each group.

CONCLUSION

In patients with diabetes and hypoglycemia, using glipizide combined with metformin did not increase the rate of hypoglycemic seizure than metformin.