For elderly patients with type 2 diabetes, treatment with the short-acting drug NovoNorm (repaglinide) may be safer and produce far fewer episodes of hypoglycemia (very low blood sugar) than treatment with longer-acting glyburide, according to Italian researchers.

The researchers conducted a 24-week crossover study of 90 diabetic patients aged 65 years or older, randomizing them to take NovoNorm at mealtime or to twice-daily take Euglucon (glyburide).

They reported in the journal Diabetes Care that the frequency of low blood sugar episodes was 51 percent lower with NovoNorm than with glyburide, at 0.38 versus 1.4 episodes per 12-week period per patient. Results were similar in a subgroup of patients aged 75 years or older.

"The major clinical implication of our study," said Dr. Francesco Purrello, "is that short-acting hypoglycemic drugs, such as repaglinide, should be used in elderly individuals instead of long-acting compounds, such as glyburide, to decrease the risk of hypoglycemic reactions that may be extremely dangerous in these patients."