Vol. 7, Issue 1, Part A (2025)

Background: Type 2 diabetes mellitus (T2DM) requires effective glycemic control to prevent complications. Glimepiride and teneligliptin, in combination with metformin, are widely used, but comparative efficacy data are limited. Objective: To evaluates the efficacy of glimepiride-metformin versus teneligliptin-metformin in T2DM management. 
Methods: A randomized comparative study was conducted at Department of Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh, from January 2023 to December 2024. A total of 60 T2DM patients were randomly assigned into two groups: Group 1 (glimepiride + metformin, n=30) and Group 2 (teneligliptin + metformin, n=30). Baseline and post-intervention glycemic parameters, including fasting plasma glucose (FPG), postprandial plasma glucose (PPG), and glycated hemoglobin (HbA1c), were analyzed using SPSS version 23.0. 
Results: In this study, HbA1c reduction was greater in the teneligliptin group (−1.5%) compared to the glimepiride group (−1.2%). Postprandial glucose decreased significantly with teneligliptin (−48.6 mg/dL) versus glimepiride (−38.2 mg/dL). Hypoglycemia was lower in the teneligliptin group (4.2%) than in the glimepiride group (12.5%). Weight gain was observed in 10.3% of glimepiride users, while teneligliptin maintained stable weight. 
Conclusion: This study demonstrates that teneligliptin, in combination with metformin, provides superior postprandial glucose and HbA1c reduction compared to glimepiride while minimizing hypoglycemia risk and weight gain. Both regimens effectively manage type 2 diabetes mellitus, but teneligliptin offers better safety and metabolic stability, making it a preferable choice for long-term glycemic control.