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T2D Medicine Meglitinide

T2D Medicine Meglitinide

Meglitinide (Repaglinide) diabetes drug helps the body to make more insulin right after meals, thus blood-glucose rise is limited after eating.

Glinides are non-sulphonylureas members of a new pharmacologic class of rapid-acting insulin-secretion agents. You can combine this with metformin, TZDs or alpha-glucosidase inhibitors.

Meglitinide mechanism of action

Non-Sulphonylureas agent Glinide’s work is similar to sulfonylureas to facilitate glycemic control; however, they have a much shorter metabolic half-life. It stimulates a rapid but short-lived release of insulin from pancreatic beta-cells that lasts for one to two hours. You need to take this drug along with every meal.

When taken with meals, it lower postprandial glucose level and decreases hypoglycemia risk during late postprandial phase, because of less insulin secretion several hours after the meal. Glinides target postprandial blood-glucose levels rather than fasting blood-glucose levels.

Meglitinide’s diabetes medications

  • Generic name: Repaglinide (Brand name: Prandin in the USA; Gluconorm in Canada; Q-Repa, Regan, Repide, Restrict in India;  NovoNorm in other countries)
  • Generic name: Nateglinide (Brand name: Starlix in Canada, United Kingdom, United States, Philippines, and other countries; Glinate, Nds in India; Nateglinide Watson, Nateglinide in the United States).

Meglitinide’s dosage

  • Repaglinide – start with a minimum dose of 0.5 mg with meals, maximum dose 4mg with meals (not exceeding 16mg daily).
  • Nateglinide – begin with a minimum dose of 60 mg with meals, maximum dose 120mg with meals (not exceeding 360mg daily).

What can you expect for Meglitinide?

A short-term study shows repaglinide and nateglinide lower: 

  • fasting blood glucose (FPG) by 31 mg/dl or 1.722 mmol/l
  • Postprandial blood glucose by 13 mg/dl or 0.722 mmol/l and
  • hemoglobin A1C by 0.6% and 0.4%.

Longer studies with repaglinide demonstrate a decrease in hemoglobin A1C of 1.4 to 1.8%. You can use glinides as monotherapy and in combination with most other oral diabetes drugs and insulin.

Who can benefit from Meglitinide?

It is a suitable option for patients with a severe sulfa allergy who are not candidates for sulfonylurea therapy. Meglitinides has less hypoglycemic effect compared to sulfonylurea.

Who should avoid using Meglitinide?

This drug is metabolizing by the liver, cleared by the kidney, and should use with caution in patients with hepatic or renal impairment. However, repaglinide class of drug is only less strain on the kidney and can, therefore, use safely in patients with renal impairment. It should be titrated cautiously in elderly patients and those with renal or hepatic dysfunction.

Avoid Repaglinide / Prandin, if you are pregnant (or planning to get), breastfeeding, or having liver disease.

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