Meglitinides for type 2 diabetes

Meglitinides for Type 2 Diabetes

Examples

Generic Name	Brand Name
nateglinide	Starlix
repaglinide	Prandin
repaglinide and metformin	Prandimet

Nateglinide (Starlix), repaglinide (Prandin), and the combination medicine repaglinide and metformin (Prandimet) help stop the rapid rise in blood sugar levels that can occur immediately after a person with type 2 diabetes eats.

How It Works

Meglitinides prevent a rise in blood sugar levels by increasing the amount of insulin produced by the pancreas, similar to the way sulfonylurea medications work.

Why It Is Used

Meglitinides can be used to treat type 2 diabetes in people whose blood sugar levels have not stayed within a target range using diet and exercise.

Meglitinides can be used along with metformin if diet, exercise, and metformin or repaglinide alone have not kept blood sugar levels within a target range. The dose of each may need to be adjusted to prevent low blood sugar.

Because meglitinides work quickly and do not stay in the body long, they need to be taken at or just before each meal. This allows flexibility for people who do not eat on the same schedule each day.

People who have liver problems may not be able to take repaglinide. And it is unknown whether the medicine is safe for use during pregnancy.

How Well It Works

Repaglinide has been found to be safe and effective in adults who have type 2 diabetes. Some older adults may be more sensitive to side effects.

One study found that repaglinide was as safe and effective as glyburide (one of the sulfonylurea medicines) in treating people who have type 2 diabetes.¹

Repaglinide has not been studied in children, pregnant women, or women who are breast-feeding.

Side Effects

Side effects of repaglinide are similar to those of sulfonylurea medicines and include:

Low blood sugar.
Upper respiratory infections, nasal and sinus inflammation, and bronchitis.
Joint pain.
Nausea.
Weight gain.

Repaglinide may cause low blood sugar and weight gain, but these side effects are milder than in those people who take glyburide.²

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Repaglinide should only be taken just before or during a meal. It can cause low blood sugar if you do not eat right away. If you miss a meal, do not take that dose of medicine. If you eat an extra meal, add a dose for that meal.

Repaglinide acts quickly, so take it before you start eating or with your first few bites of food. It will have the greatest effect within 30 minutes to an hour. And it will work for about 3 hours.

If you have kidney or liver disease, you may not be able to take these medicines. Talk with your doctor.

Children

Few studies have been done on the use of oral medicines for type 2 diabetes in children. And these medicines have not been approved by the U.S. Food and Drug Administration (FDA) for use in children. But because these oral medicines are safe for adults, most doctors use them to treat children who have type 2 diabetes.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

Rosenstock J, et al. (2004). Repaglinide versus nateglinide monotherapy. Diabetes Care, 27(6): 1265-1270.

Lebowitz HE (2005). Management of hyperglycemia with oral antihyperglycemic agents in type 2 diabetes. In CR Kahn et al., eds., Joslin's Diabetes Mellitus, 14th ed., pp. 687-710. Philadelphia: Lippincott Williams and Wilkins.

Answer:

Your level is currently NormalHigh (hyperglycemia).Low (hypoglycemia).

If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Your blood sugar level is slightly high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is currently normal. However, if you are concerned about diabetes speak with your physician. There may be other risk factors that increase your risk for diabetes.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level may be high, depending on when you last ate. If you have not eaten for at least 8 hours, your blood sugar should be less than 100. If you've eaten within the last 2 hours, your blood sugar should be less than 140. You should call your health care provider and ask if you need laboratory tests to check for diabetes. If you are pregnant always consult with your health care provider.

Blood sugars consistently above 180 warrant prompt medical attention.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level is high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.

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