背景：本研究主要目的為評估門診第二型糖尿病患轉換複方降血糖藥物前後療效分析。並針對初診斷為糖尿病及原本使用單方病患，評估醫師處方複方降血糖藥物的合理性。
方法：本研究設計為回溯性病歷回顧，由某醫學中心醫囑電腦系統資料庫抽選初次服用Metformin及Glibenclamide之複方劑型GlucoMet病患，，並篩選出由降血糖藥物等量轉換至GlucoMet病患，比較轉換複方藥物前後血糖控制差異。另篩選初診斷為糖尿病及單方轉換複方之病患，，判別醫師處方複方藥物的時機是否合理。
結果：研究區間以亂數抽取900位病患，刪除用藥記載不全樣本。共743位病患納入研究，其中157位病患為等量轉換至複方GlucoMet，且轉換前後有定期監測HbA1C值。其轉換為GlucoMet後達血糖治療目標比例為18.5%；HbA1C平均值為7.9±1.1% 。另針對12位初診斷糖尿病，其中1位病患服用前僅監測飯後血糖值，判定屬不合理處方；另68位原本使用單方降血糖藥物的病患，其中有4位病患轉換前之HbA1C值已達治療目標，醫師仍使用複方增加病患口服降血糖藥物種類，判定屬不合理處方。

結論：本研究中，157位病患等量轉換為GlucoMet後，達血糖治療目標比例為18.5%，相較於轉換前15.3% (P=0.652)未達統計上顯著差異；平均HbA1C值為7.9±1.1%，相較於轉換前8.1±1.2% (P=0.024)具有統計上顯著差異。

Background: This study was to investigate the efficacy of type II diabetes outpatients switched from co-administration of sulfonylurea and metformin to fixed-dose combination of glibenclamide and metformin (GlucoMet). Besides, for first diagnosed diabetic patients and who have received monotherapy, we assess the rationale for converting anti-diabetic drugs.
Methods: A retrospective chart review study of type 2 diabetes outpatients treated at a medical center was performed. We reviewed the medical records and recorded the dosage of the anti-diabetic drugs before and after switching to GlucoMet. For the first diagnosed diabetic patients and who have received monotherapy, we evaluated the timing of combination therapy.
Results: 743 patient records were identified and included in the analysis, 157 patients have taken the same dosage of sulfonylurea and metformin before and after switch to fixed-dose combination tablet and had greater reductions in HbA1C compared to sulfonylurea co-administered with metformin (7.9 ± 1.1 vs. 8.1 ± 1.2; P = 0.024). One of twelve new diagnosed diabetes patients received combination therapy without monitoring fasting blood glucose or HbA1C and was recognized as a drug-related problem needed intervention; 4 of the 68 patients who have received monotherapy had reached their treatment goals, however, GlucoMet was still prescribed for these patients.
Conclusions: Patients switched from co-administered sulfonylurea with metformin to GlucoMet experienced an overall mean decrease in HbA1C, and to reach treatment goals of blood glucose increased by 3.3%. After assessment, most of the prescriptions in this medical center are recognized as reasonable.