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Non-Sulfonylurea Insulin Secretagogues
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Non-Sulfonylurea Insulin Secretagogues
, Meglitinide, Repaglinide, Prandin, Nateglinide, Starlix
See Also
Second Generation Sulfonylurea
Type II Diabetes Medications
Mechanism
Insulin
secretogogue
Indication
Early
Type II Diabetes Mellitus
Oral Agent
Elevated postprandial
Glucose
Consider if only used intermittently pre-meal
Contraindications
Hypersensitivity Reaction
to sulfa
Category
Insulin Secretagogue
Mechanism
Benzoic acid derivative
Similar to
Sulfonylurea
Binds different sites from
Sulfonylurea
s
Closes ATP sensitive K+ channels
Results in
Insulin
secretion
Shorter duration of binding and shorter effect
Predominately effects postprandial
Glucose
Advantages
Low risk of
Hypoglycemia
(2.4%)
Effect depends on
Ambien
t
Blood Glucose
levels
No significant gastrointestinal side effects
Minimal weight gain
No lab monitoring required
No significant
Drug Interaction
s
No
Lactic Acidosis
No adjustments needed (other than per meal)
No adjustment in
Congestive Heart Failure
No adjustment for age
No adjustment in
Renal Insufficiency
Adverse Effects
Hypoglycemia
(lower risk of
Sulfonylurea
s)
Disadvantages
Two to three times as expensive as
Sulfonylurea
s
Agents
Repaglinide (Prandin)
Nateglinide (Starlix)
Significantly weaker activity compared with Prandin
References
Luna (2001) Am Fam Physician 63(9):1747-56 [PubMed]
Luna (1999) Prim Care 26:895-915 [PubMed]
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