Last updated May 6, 2026
Key finding
In Indian adults with type 2 diabetes not controlled on metformin alone, the fixed-dose triple combination of glimepiride, voglibose, and extended-release metformin lowered HbA1c more than either dual combination over 24 weeks, with few mild side effects.
This 24-week Indian trial compared a triple fixed-dose tablet with two dual-drug tablets in adults with type 2 diabetes who were still above target on metformin alone. All groups improved, but the triple combination lowered HbA1c more and helped more people reach an HbA1c below 7%, without more serious safety problems.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
Randomized Controlled Trials (RCTs)
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
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Study focus
In Indian adults with type 2 diabetes not controlled on metformin alone, the fixed-dose triple combination of glimepiride, voglibose, and extended-release metformin lowered HbA1c more than either dual combination over 24 weeks, with few mild side effects.
Published in
Publication details and source links for this paper.
Mohan B, Kumar SV, Kurmi PH, et al. Efficacy and Safety of Glimepiride, Voglibose, and Metformin ER in Type 2 Diabetes: A Randomized, Active-Controlled Study. J Diabetes. 2026;18(4):e70217. doi:10.1111/1753-0407.70217
HbA1c ↓ by 1.57% at 24 weeks with triple therapy
More patients reached HbA1c <7% with triple therapy
Fasting glucose ↓ in all treatment groups
Postprandial glucose ↓ in all treatment groups
Hypoglycemia ↔ rare and no severe events were reported
Evidence network
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This study contributes evidence to Glimepiride + voglibose + metformin, Metformin + glimepiride, Voglibose + metformin and Adverse events incidence, HbA1c, Hypoglycemia events.
This study contributes evidence to
Primary intervention
Glimepiride + voglibose + metformin
Primary outcomes
Evidence topics
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
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2
Related topics
9
Evidence pairs
222
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Contributes evidence
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Contributes evidence
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Primary evidence
Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Glimepiride + voglibose + metformin → Adverse events incidence
Glimepiride + voglibose + metformin → Adverse events incidence
Glimepiride + voglibose + metformin → Hypoglycemia events
Glimepiride + voglibose + metformin → Hypoglycemia events
Metformin + glimepiride → Adverse events incidence
Metformin + glimepiride → Adverse events incidence
Metformin + glimepiride → Hypoglycemia events
Metformin + glimepiride → Hypoglycemia events
Voglibose + metformin → Adverse events incidence
Voglibose + metformin → Adverse events incidence
Voglibose + metformin → Hypoglycemia events
Voglibose + metformin → Hypoglycemia events
Evidence Library
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These findings apply most directly to adults aged 18 to 65 years with type 2 diabetes in India who remain above target despite stable metformin monotherapy, and who do not have major renal, hepatic, or gastrointestinal exclusion conditions. The results are most relevant to patients with HbA1c between 7.5% and 9.0%.
All three treatments improved glucose control, so the main question is the size of the extra benefit from the triple combination. The primary endpoint was an objective lab measure, which strengthens confidence, but the open-label design and industry funding still matter. The study also used fixed-dose combinations and dose uptitration rules that may not fully match every real-world setting.
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Metformin Therapies and HbA1c, Metformin Therapies and Hypoglycemia.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies measuring Hypoglycemia
Measures Hypoglycemia as a key outcome.
All studies on Metformin Therapies
Contributes to Metformin Therapies evidence base.
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2 results
2 results
2 results
2 results
2 results
Generated from the study's connected evidence using Evidence Intelligence™.
Metformin Therapies may improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 8 supporting studies with consistent results and a positive effect signal.
Limitations
Metformin Therapies may improve Hypoglycemia.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Hypoglycemia events
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | weak positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 3 supporting studies with consistent results and a positive effect signal.
Limitations
Glimepiride + voglibose + metformin appears to improve HbA1c.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Glimepiride + voglibose + metformin may improve Adverse events incidence.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Adverse events incidence
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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