Type 2 Diabetes represents a worldwide challenge for health care. However, combined administration of stevia extract 300 mg/kg/day and glimepiride 1 mg/kg/day to diabetic rats orally caused a significant increase (p < 0.05, Figure 5) in the HDL level as compared to rats treated with glimepiride alone. -, BJU Int. Keywords: 2011 May 17;154(10):672-9. doi: 10.7326/0003-4819-154-10-201105170-00007. After that, blocking of the endogenous peroxides activity by H2O2 (3%) was performed. leaves and stevioside ameliorates lipopolysaccharide induced acute liver injury in rats,, S. P. Wolff and R. T. Dean, Glucose autoxidation and protein modification: the potential role of autoxidative glycosylation in diabetes,, J. L. Rains and S. K. Jain, Oxidative stress, insulin signaling, and diabetes,, S. Ghanta, A. Banerjee, A. Poddar, and S. Chattopadhyay, Oxidative DNA Damage Preventive Activity and Antioxidant Potential of. The effect of glargine versus glimepiride on pancreatic -cell function in patients with type 2 diabetes uncontrolled on metformin monotherapy: open-label, randomized, controlled study. Before Position statement of, International Diabetes Federation treatment algorithm, International Diabetes Federation treatment algorithm for people with type 2 diabetes. Influence of dipeptidyl peptidase-4 inhibitors on glycemic variability in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Vildagliptin improved all post-oral fat load peaks of lipid profile compared with glimepiride. The main problems in diabetes that leading to hepatogenous diabetes are insulin sensitivity and - cell failure [48]. Vildagliptin treatment was associated with less fluctuation of glucose levels than glimepiride treatment as assessed by 24-h CGM device, suggesting vildagliptin may have the potential to offer long-term beneficial effects for patients with T2DM in preventing the development of complications of diabetes. These results are collaborated with previous result [32,33,34], that stevia extract decreased total cholesterol level and elevated the HDL-cholesterol level. Therefore, it appears that stevia extract and glimepiride could give a potential therapeutic effects in diseases linked to impairment of glucose tolerance, hyperlipidemia and increased insulin resistance. Most of diabetic patients often complain of secondary failure after prolonged treatment with sulfonylureas (SUs) [3]. It may be used alone, or in combination with insulin or another oral medicine such as metformin. Treatment of diabetic rats with stevia extract expressed a significant decrease in renal indicators (urea and creatinine). Diabetes Care. Conclusion: Stevia and glimepiride may be a new putative therapeutic regimen for management of type 2 diabetes and its complications. Background: The currently therapy of type 2 diabetes is unsatisfactory. 2016 Jun;52(3):458-80. doi: 10.1007/s12020-015-0841-1. Aims: Would you like email updates of new search results? Significant decrease of the liver injuries was appeared in the group ofstevia (Figure 9F&G). 1Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt, 2Department of Pharmacognosy, Faculty of Pharmacy, Assiut University, Assiut, Egypt, 3Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt, Received 1 September 2019; Accepted 10 November 2019. HHS Vulnerability Disclosure, Help The present study evaluates possible drug interactions between glimepiride (GLIM) and sildenafil citrate (SIL) in streptozotocin (STZ)-induced diabetic nephropathic (DN) animals and also postulates the possible mechanism of interaction based on molecular modeling studies. ), vascular congestion (2.33 0.21) and mild dilation of glomeruli with glomerular capillaries congestion (1 0.0) (Figure 10C).The mean score of the renal injuries (1.99 0.50) was significantly more than normal group (p = 0.037). Learn more. Treatment of diabetic rats with stevia extract (300 mg/kg/day) caused a significant decrease in the serum cholesterol (P < 0.05, Figure 3) in comparison to untreated rats. The cause of erectile dysfunction in men with diabetes is usually related to a decrease in the blood interaccion to the penis as well as to injury to the nerves that are responsible for the erection mechanism. Federal government websites often end in .gov or .mil. There are 454 drugs known to interact with glimepiride, along with 5 disease interactions, and 1 alcohol/food interaction. The percentage of positive cells was scored as: 0 = negative, 1 = (<10%), 2= (10% - 50%) and 3(> 50%). Diabetes Care. doi: 10.1042/BSR20221108. Combined treatment administration of stevia extract and glimepiride to diabetic rats withcaused more improvement in renal function. We viagra a study where a patient was hospitalized and diagnosed with gastrointestinal . Thus, identification of new therapeutic antidiabetic regimens that are beneficial for patients with T2DM is of great need [2]. The significance level was taken at P< 0.05, P< 0.01 and P< 0.001. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Glimepiride is and by Sanofi Bangladesh Limited. It is created by eHealthMe based on reports of 239 people who take Glimepiride and Cialis from the FDA, and is updated regularly. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Immunohistochemical expression of endothelial nitric oxide (eNOS) was assessed in renal tissues. The study is created by eHealthMe based on reports of people who take Glimepiride and Cialis from the FDA, and and updated regularly. An official website of the United States government. The secondary staining kit (Thermo Scientific Corporation; Fremont, CA, USA) was used based on manufacturer's instructions. Reproduced with kind permission from Inzucchi SE, Bergenstal RM, Buse JB, et al. MAGE was reduced by 20% with vildagliptin versus glimepiride. Rats were given water and food ad libitum. Amaryl M 4/500 Mg. Management of hyperglycemia in type 2 diabetes: a patient-centered approach. Adiponectin levels were higher (P = 0.035) and high-sensitivity C-reactive protein levels were lower (P = 0.038) with vildagliptin vs glimepiride. government site. . Deparaffinization and rehydration of the sections (four m thick) were done. Get started. Hossen MS, Samad A, Ahammad F, Sasa GBK, Jiang Z, Ding X. Biosci Rep. 2022 Nov 30;42(11):BSR20221108. Sodium-glucose cotransporter2 inhibitors reduce day-to-day glucose variability in patients with type1 diabetes. 1998;352(9131):837853. Epub 2014 Apr 23. 2012, Springer Science and Business Media. Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Effects of one year treatment of vildagliptin added to pioglitazone or glimepiride in poorly controlled type 2 diabetic patients. Toggle . Glimepiride 4mg Tablets. The staining intensity was scored as: 0: negative, 1: weak, 2: moderate and 3: strong. 2020 Nov 24;14:5179-5187. doi: 10.2147/DDDT.S275343. The Diabetes Control and Complications Trial Research Group. Park KS, Kwak S, Cho YM, Park KS, Jang HC, Kim SY, Jung HS. Epub 2013 Dec 2. MDA has a main role in pathogenesis of many chronic diseases like diabetes [24]. The mean score of liver injuries (0.02 0.02) was significantly lower than diabetic control rats (p = 0.003). The mean of eNOS protein expression was significantly less than diabetic rats (p = 0.003). Lukashevich V, Del Prato S, Araga M, Kothny W. Diabetes Obes Metab. HHS Vulnerability Disclosure, Help Stevia extract was prepared as solution (dissolve in saline), while glimepiride was dissolved in 0.5 % tween 80. Effect of different treatment on lipid profile level. Effect of dipeptidyl-peptidase-4 inhibitors on C-reactive protein in patients with type 2 diabetes: a systematic review and meta-analysis. Hemmingsen B, Sonne DP, Metzendorf MI, Richter B. Cochrane Database Syst Rev. -, Exp Clin Endocrinol Diabetes. The diabetic groups were treated for 21 days as the following, the first with stevia extract (300 mg/kg), the second with glimepiride (1 mg/kg), and the third with a combination of glimepiride and stevia extract. Methods: 2007 Feb;115(2):69-84 Table 1: Influence of stevia and/or glimepiride on blood glucose levels of diabetic rats. Despite a similar decrease in HbA1c levels (P = 0.009, and P = 0.008, respectively), body weight increased with glimepiride (P = 0.048 vs baseline) and decreased with vildagliptin (P = 0.041 vs baseline and vs glimepiride). 2008 Mar;(159):15-23. doi: 10.1111/j.1742-1241.2007.01692.x. Our findings demonstrated that stevia extract reduced the serum level of hepatic enzymes in diabetic rats. Conch shell natural viagra for combien temps viagra fait effet. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Treatment with stevia extract is leading to enough antihyperglycemic action, with a little risk for hypoglycemia, reduced body weight, and other beneficial health effects like antioxidant, hepatic and renal protection [9,10]. Diabetic nephropathy represents a complex metabolic process characterized with patho-physiological events that both stimulate and depress intra-renal nitric oxide (NO) production. Stevia reduced eNOS expression in renal tissues compared to the diabetic rats. The stevia enhanced the influence of glimepiride on the level of triglycerides. Moon JS, Ha KS, Yoon JS, Lee HW, Lee HC, Won KC; BETA study group. Drug Des Devel Ther. To cialis properly, the amount of glimepiride you take must be balanced against the amount and type of food you eat and the amount of exercise interaccion do. Occurrence of T2DM was insured by measuring the blood glucose level, 72 h from I.P administration of steptozotocin. Co-administration of glimepiride and stevia extract produced significant improvement of all the hepatic injuries except for mild hydropic degeneration (0.16 0.16) (Figure 9I). Effects of dapagliflozin vs vildagliptin on cardiometabolic parameters in diabetic patients with coronary artery disease: a randomised study. Nowadays, there is a great interest in using the medicinal plants for treatment of diabetes. These features is mostly due to elevation in the rate of lipolysis from insulin-resistant adipocytes [30] which, decreases the glucose uptake in the muscles, enhances triglyceride formation, exaggerates glucose synthesis in the liver, and leading to failure of -cell [31]. 2014 Nov;122(10):597-601. doi: 10.1055/s-0034-1382034. Characterization of the molecular mode of action of the sulfonylurea, glimepiride, at adipocytes. 2017 Mar;8(2):218-226. doi: 10.1111/jdi.12572. on the 29th and 70th day of the protocol. Thus, United Kingdom Prospective Diabetes Study (UKPDS) demonstrated that single therapy of oral antidiabetic drugs usually shows a failure in the regulation of euglycemic state through a long time, and most of diabetics need to change this monotherapy to eighter combinations of oral antidiabetic drugs or insulin therapy [3]. On eHealthMe, you can interaction real-world data from 16 cialis patients, and personalize the glimepiride to your gender and age. ), portal inflammation (1.16 0.30) (Figure 9D. Both SE and stevioside inhibited CP nephrotoxicity by reducing the level of TNF- [39]. The pro-inflammatory cytokine tumour necrosis factor TNF- has been involved as a key element in the development and progression of obesity, insulin resistance and T2DM, doing its effect via the process of inflammation and immunity [37]. Oxidative stress is also claimed to have an important role in pathogenesis of T2DM. It is often taken by patients suffering from depression and receiving antidepressant drug treatment. It is used along with diet and cialis, and sometimes with other drugs, to treat interaction 2 diabetes. Epub 2009 Mar 19. Medically reviewed by Drugs.com. Side effects include headache, dizziness, cialis rash. and transmitted securely. Conclusions: Vildagliptin was more effective than glimepiride in reducing post-oral fat load peaks of lipid-trafficking adipocytokines and inflammatory markers. Results: Both vildagliptin and glimepiride reduced postprandial glucose levels, based on both CGM data (15% vs. 16%) and measured plasma glucose (13% vs.17%). Common medications used by patients with type 2 diabetes mellitus: what are their effects on the lipid profile? With medical big data and AI . The studies demonstrate that early diabetic nephropathy is associated with increased constitutive NO production derived mainly from eNOS and possibly iNOS and this effect may be related to intra glomerular hemodynamic changes noted in early diabetic renal disease [44]. A total of 24 patients (age: 58.3 5.56 years, baseline HbA1c: 7.6 0.50%) who were on stable metformin monotherapy (500-3000 mg) were enrolled, and all completed the study. 2019 Jun 18;18(1):144. doi: 10.1186/s12944-019-1086-4. The diabetic groups were treated for 21 days as the following, the first with stevia extract (300 mg/kg), the second with glimepiride (1 mg/kg), and the third with a combination of glimepiride and stevia extract. Unable to load your collection due to an error, Unable to load your delegates due to an error. Berberine is enalapril safe when used orally or topically for the short-term. Use viagra medication regularly in cialis to get the most benefit from it. Schwatz P, editor. Would you like email updates of new search results? To assess whether there is a difference in the effects of vildagliptin and glimepiride on glucose fluctuation in patients with type 2 diabetes mellitus (T2DM) using continuous glucose monitoring (CGM). HIV/HCV Drug Therapy Guide | Drug Interaction Guide. The .gov means its official. MeSH Studies reported that the stevia exhibits significant pharmacological activities such as: antihypertensive, antihyperglycemic, anticancer, antiobesity, anti-diarrheal and enzyme inhibitory activities [7,8]. The https:// ensures that you are connecting to the Monitor blood glucose levels on a regular basis, and share the results with your doctor. (Bertoni) on alloxan-induced diabetic rats,, A. K. Sharma and B. Srinivasan, Triple verses glimepiride plus metformin therapy on cardiovascular risk biomarkers and diabetic cardiomyopathy in insulin resistance type 2 diabetes mellitus rats,, S. Asyura, H. Hamzah, R. Shaari, S. Sithambaram, and N. Mustapha, Blood Profiles and Histopathological Changes of Liver and Kidney Tissues from Male Sprague Dawley Rats Treated with Ethanol Extracts of Clinacanthus nutans Leaf,, P. Z. Zimmet, D. J. McCarty, and M. P. De Courten, The global epidemiology of non-insulin-dependent diabetes mellitus and the metabolic syndrome,, G. Brahmachari, L. C. Mandal, R. Roy, S. Mondal, and A. K. Brahmachari, Stevioside and Related Compounds - Molecules of Pharmaceutical Promise: A Critical Overview,, D. D. Soejarto, C. M. Compadre, P. J. Medon, S. K. Kamath, and A. D. Kinghorn, Potential sweetening agents of plant origin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Bookshelf Management of DN needs controlling of many factors like: blood glucose level, hypertension and kidney function. The mean score of liver injuries (0.13 0.10) was significantly less than diabetic control rats (p = 0.004). Then, both scores were added to provide a single score (0-6). Clipboard, Search History, and several other advanced features are temporarily unavailable. Besides, these side effects, none of the available ant-diabetic drugs successfully establishing euglycemic state and treating long term micro- and macro-vascular complications. Koenig, D. Abdelatif, Y. Fazel, L. Henry, and M. Wymer, Global epidemiology of nonalcoholic fatty liver diseasemeta-analytic assessment of prevalence, incidence, and outcomes,, R. Kwok, K. C. Choi, and G. L.-H. Wong, Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: a prospective cohort study,, E. Orsi, V. Grancini, S. Menini, A. Aghemo, and G. Pugliese, Hepatogenous diabetes: Is it time to separate it from type 2 diabetes?, L. S, S. Chaudhary, and R. R.S, Hydroalcoholic extract of Stevia rebaudiana bert. Sildenafil, a phosphodiesterase type 5 inhibitor, attenuates diabetic nephropathy in STZ-induced diabetic rats. Animal handling and rights were maintained on accordance with the Ethical Committee guidelines of the Faculty of Medicine, Assuit University. As shown in Figure 1, treatment of the rats with STZ showed a significant change in the serum insulin (p < 0.001) in the form of decreasing the insulin level in comparison to non diabetic rats. This site needs JavaScript to work properly. From $8/use. PMC Diabetes mellitus (DM) is a global problem, characterized by high levels of glucose in the blood. As a short ple, a tender or difficult and cialis risk of definitions for single b et glimepiride. Administration of insulin releasing drug like glimepiride (1 mg/kg/day) to diabetic rats for the same duration showed a significant increase (p < 0.001) in the insulin level in comparison to control rats for (Figure 1). Glimepiride mitigates tauopathy and neuroinflammation in P301S transgenic mice: role of AKT/GSK3 signaling. Effect of antihyperglycemic agents added to metformin and a sulfonylurea on glycemic control and weight gain in type 2 diabetes: a network meta-analysis. Therefore, many patients with type 2 have to use sulfonylureas in adjunct with other agents that enhance insulin sensitivity and /or diabetic control [21]. 2008. While diabetic rats treated with a 300 mg/kg/day of stevia extract orally for three weeks showed a significant increase (p < 0.001) in the serum insulin level in comparison to control rats. The combined group of stevia extract (300 mg/kg) and glimepiride (1 mg/kg) showed a more reduction in the BGL compared to glimepiride alone. Bethesda, MD 20894, Web Policies official website and that any information you provide is encrypted Then, the sections were immersed in 10 mmol/l citrate buffer at pH 6.0 with further exposure to heating in a microwave at 80C for fifteen minutes to retrieve the antigens. To compare the effects of vildagliptin with those of glimepiride on glycaemic control, fat tolerance and inflammatory markers in people with Type 2 diabetes mellitus receiving metformin treatment. Molecular interaction between glimepiride and Soluplus-PEG 4000 hybrid based solid dispersions: Characterisation and anti-diabetic studies. http://www.who.int/mediacentre/factsheets/fs312/en/. However, many of artificial sweeteners like aspartame, cyclamates and saccharine, considered high calorie sugars and are potentially carcinogenics. Keywords: 2022 Oct;30(5):1871-1890. doi: 10.1007/s10787-022-01023-w. Epub 2022 Aug 3. Additionally, is has been shown to work via several extra pancreatic mechanisms. Conclusion: Stevia and glimepiride may be a new putative therapeutic regimen for management of type 2 diabetes and its complications. 2005,, MeSH Epub 2015 Dec 29. Enalapril calculations indicate that this interaction should be pressure-sensitive. Disclaimer. -. 2018 Dec 20;553(1-2):272-280. doi: 10.1016/j.ijpharm.2018.10.050. Lukashevich V, Del Prato S, Araga M, Kothny W. Diabetes Obes Metab. Glimepiride Navigate to section Drug action Indications and dose Contra-indications Cautions Interactions Side-effects Pregnancy Breast feeding Hepatic impairment Renal impairment Monitoring requirements Patient and carer advice Medicinal forms Related treatment summaries Other drugs in class Interactions View interactions for glimepiride Each patient received two 5-day treatments (vildagliptin 50 mg b.i.d. These results are in accordance with [10] and [49] who revealed the hepatoprotective effect of stevia on diabetes induced hepatic changes in diabetic rats. 2014 May;16(5):403-9. doi: 10.1111/dom.12229. Comparison of vildagliptin and glimepiride: effects on glycaemic control, fat tolerance and inflammatory markers in people with type 2 diabetes. 2015 Dec 30;496(2):741-50. doi: 10.1016/j.ijpharm.2015.11.007. Effects of Vildagliptin Add-on Insulin Therapy on Nocturnal Glycemic Variations in Uncontrolled Type 2 Diabetes. Before Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2016 Jun 30. Please enable it to take advantage of the complete set of features! Diabetologia. The https:// ensures that you are connecting to the sharing sensitive information, make sure youre on a federal 2017 Feb 27;2(2):CD009966. For regulation of the blood glucose levels as near to normal values as possible, diet control, exercise, and hypoglycemic agents are needed. J Diabetes Investig. 1996 Dec;39(12):1617-24 which permits unrestricted use, distribution, and reproduction in any medium, provided the original work The combined use of glimepiride and stevia extract considered as a novel approach to glycemic control and is accompanied by multiple demonstrable metabolic and renal benefits beyond its glucose-lowering effect. [Cialis], vardenafil [Levitra] and avanafil [Stendra], which work in . Conclusions: Our finding demonstrated a significant reduction in blood glucose level in glimepiride treated rats. Clipboard, Search History, and several other advanced features are temporarily unavailable. Efficacy and safety of vildagliptin in patients with type 2 diabetes mellitus inadequately controlled with dual combination of metformin and sulphonylurea. STZ induced-renal damage is confirmed by both diagnostic biochemical parameters and histopathological changes [10]. Abdel-Azim Assi, Doaa H. Abd El-hamid, Mahran S. Abdel-Rahman, Esraa E. Ashry, Soad AI Bayoumi, and Asmaa M. Ahmed, "The Potential Efficacy of Stevia Extract, Glimepiride and Their Combination in Treating Diabetic Rats: A Novel Strategy in Therapy of Type 2 Diabetes Mellitus," Egyptian Journal of Basic and Clinical Pharmacology, Vol. The majority of diabetic peoples take sweeteners with low calories in order to reduce the caloric entry. Dipeptidyl-peptidase (DPP)-4 inhibitors and glucagon-like peptide (GLP)-1 analogues for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk for the development of type 2 diabetes mellitus. Several studies have demonstrated that glimepiride increase adiponectin gene expression in adipocytes [27] and other data have also revealed that glimepiride may cause enhancement in insulin sensitivity which linked to increased serum adiponectinemia [28]. Also, data on humans revealed that administration of stevia extract elevated the level of HDL and decreased the levels of cholesterol, triglycerides [35]. Forty eight wistar rats were classified into following groups: Group I: received saline (Control-non diabetic); Group II: received saline (control diabetic); Group III: received 0.05% tween 80 (control diabetic); Group IV: diabetic rats treated with 300 mg/kg aquatic extract of stevia; Group V: diabetic rats treated with 1 mg/kg glimepiride; Group VI: diabetic rats treated with 300 mg/kg aquatic extract of stevia combined with 1 mg/kg glimepiride. This is an open access article distributed under the Creative Commons Attribution License, Glimepiride is a second-generation sulfonylurea that stimulates pancreatic cells to release insulin. Along with its needed effects, glimepiride may cause some unwanted effects. Accessibility Epub 2016 Oct 12. The study, conducted by researchers at Vanderbilt University School of Medicine, found that people with prediabetes became more sensitive to insulin when treated with Viagra - suggesting that the erectile dysfunction . L: Third dayan adaptor protein that occurs glimepiride versus abnormal, as the torque these for peripheral autonomic ganglia results in johannesburg and interactions. continuous glucose monitoring; glimepiride; type 2 diabetes mellitus; vildagliptin. The prevalence of NAFLD was very high among diabetic patients reaching upto 70% between these patients [47]. 2017 May 10;5(5):CD012204. Leaves of Stevia rebaudiana Bertoni, family Asteraceae were obtained from farm in Assiut, Egypt during the flowering stage (April to July 2016). Vildagliptin was more effective than glimepiride in reducing post-oral fat load peaks of lipid-trafficking adipocytokines and inflammatory markers. The same active ingredients as Cialis and Viagra at different dosages. Diabetes mellitus was the 7 th cause of mortalities by ranking of the World Health Organization in 2016 and is projected to move up by 2030 [15,16]. Systematic review and meta-analysis of vildagliptin for treatment of type 2 diabetes. 2014 May;16(5):403-9. doi: 10.1111/dom.12229. Unauthorized use of these marks is strictly prohibited. PMC As shown in Figure 2, administration of 300 mg/kg/day of stevia extract to diabetic rats for three weeks showed a significant elevation in the adiponectin level. Study design: An open, randomised controlled cialis. The mean score of renal injuries (0.11 0.11) was significantly lower than untreated diabetic rats (p = 0.046). Since these medications are not cialis broken down, they stick around and hang out in your system. Li FF, Shen Y, Sun R, Zhang DF, Jin X, Zhai XF, Chen MY, Su XF, Wu JD, Ye L, Ma JH. Combined administration of glimepiride 1 mg/kg/day and stevia extract 300 mg/kg/day to diabetic rats showed a significant reduction (p < 0.001) in the tumor necrosis factor level as compared to control rats. Our immunohistochemical results are in line with these data with regard to strong eNOS protein expression in the renal tissue of STZ- injected rats. MeSH An official website of the United States government. HHS Vulnerability Disclosure, Help NHS medicines information on glimepiride - what it's used for, side effects, dosage and who can take it. AS shown from Figure 6, treatment of the rats with STZ caused a significant elevation (p < 0.001) in the serum level of TNF-. and SIL (2.5 mg kg(-1), p.o.) The concentration of SIL increased significantly (P < 0.001) in rat plasma when co-administered with GLIM on the 70th day of the protocol. Zaki MO, El-Desouky S, Elsherbiny DA, Salama M, Azab SS. Ann Intern Med. Manufacturer advises adjust dose. The combination of stevia & glimepiride significantly reduced the mean score of hepatic injuries than those treated with glimepiride alone. Methods: Bookshelf These findings were in accordance with previous results [12]. However, sulfonylureas have no influence on insulin resistance (IR), the main cause and complication in type 2 diabetes mellitus. 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