Diabetes Mellitus:  Lipids



The meglitinides are non-sulfonylurea insulin secretogogues.  The current agents in this class,  Repaglinide (Prandin) and Nateglinide (Starlix), are notable for very rapid onset and short duration of action.  As will be discussed, these characteristics have significant benefits in some patients, but as opposed to the sulfonylurea drugs, these agents must be dosed on a premeal schedule for most patients.

Unlike sulfonylureas, repaglinide and nateglinide stimulate first-phase insulin release in a glucose-sensitive manner.  Theoretically this would reduce the risk of hypoglycemic events, but studies have failed to show this to be clinically evident.  I will comment on why I believe this has been the case, and may not always be true.

Finally, these drugs are extremely expensive.  The cost is 3-5 times that of the commonly used sulfonylurea agents (as these drugs are available generically).

Section  Details:


Mechanism of Action


Side Effects


Required Screens:  4
Optional Screens:   4