Efficacy and Safety of Metformin, Injectable Insulin, and Sulfonylureas in Type 2 Diabetes Management: A Comparative Evaluation in Libyan Patients

Malak Dakeal; Mawada Hedwar; Mona Enbeis; Sumaya Albdwy

doi:10.54361/ajmas.269519

Authors

Malak Dakeal Department of Medical Technology, Alawata College of Applied Sciences and Technology, Libya https://orcid.org/0000-0002-8419-1187
Mawada Hedwar Department of Pharmaceutical Technology, Higher Institute of Science and Technology, Souk El Khemis, Imsehel, Libya https://orcid.org/0000-0001-6559-4637
Mona Enbeis Department of Pharmaceutical Technology, Higher Institute of Science and Technology, Souk El Khemis, Imsehel, Libya https://orcid.org/0009-0006-3033-1697
Sumaya Albdwy Department of Pharmaceutical Technology, Higher Institute of Science and Technology, Souk El Khemis, Imsehel, Libya https://orcid.org/0009-0006-3033-1697

DOI:

https://doi.org/10.54361/ajmas.269519

Keywords:

Type 2 Diabetes Mellitus, Metformin, Insulin, Sulfonylureas, Glycemic Control, Renal Function, Hepatic Function, Combination Therapy, HbA1c, Libya.

Abstract

Type 2 Diabetes Mellitus (T2DM) is a major health burden in Libya, where metformin, sulfonylureas, and insulin remain the main therapeutic options. This study evaluated the efficacy and safety of these agents, alone and in combination, with emphasis on glycemic control and organ function. A cross-sectional analysis was conducted at the Diabetes and Endocrinology Hospital in Tripoli between September 2025 and January 2026, enrolling 81 patients aged 30–75 years with confirmed T2DM. Participants were assigned to five therapeutic groups, and fasting blood glucose, HbA1c, renal indices, and hepatic enzymes were measured. Combination therapy, particularly insulin plus metformin, achieved superior glycemic control with lower HbA1c compared to sulfonylurea monotherapy. Renal impairment was most evident in the sulfonylurea plus metformin group, while hepatic enzyme elevations were more pronounced with sulfonylurea alone. In contrast, insulin plus metformin demonstrated more favorable hepatic outcomes. These findings highlight the advantages of combination therapy but emphasize the need for individualized treatment and careful monitoring of renal and hepatic function in resource-limited settings.