What to Know About Meglitinides

Meglitinides are oral medications used to treat type 2 diabetes. They work by triggering production of insulin. Medications in this class include Prandin (repaglinide) and Starlix (nateglinide).

Uses

In the human body, insulin is produced by specialized cells in the pancreas called beta cells. In people with type 2 diabetes, the pancreas either doesn't produce enough insulin or the body doesn't use insulin efficiently. In both scenarios, blood glucose (sugar) levels are hard to control.

Meglitinides stimulate beta cells to produce more insulin, allowing the body to better process glucose, thereby lowering blood sugar levels. This particular class of medication is meant to help lower blood sugars after meals, and is particularly helpful for those with flexible schedules and when consistent mealtimes aren't always possible.

Meglitinides have been approved by the U.S. Food and Drug Administration for type 2 diabetes since 1997. The first drug in this class, repaglinide, was approved in 1997, and a second, nateglinide, was approved in 2000.

Meglitinides can be used alone or in combination with other medications.

Before Taking

Meglitinides do not directly reduce blood sugar and therefore are not a substitute for insulin. They should be taken in conjunction with making lifestyle changes, such as following a low-carb diet and increasing physical activity.

Precautions and Contraindications

Studies indicate repaglinide is comparable to other oral diabetes medications in lowering blood sugar. Nateglinide, while useful, may be somewhat less effective at lowering blood sugar levels than other anti-diabetes medications.

People with type 1 (insulin-dependent) diabetes or allergies to meglitinides should not use them. Those currently experiencing physical stress caused by infection, injury, or surgery may need to temporarily stop taking meglitinides. People with kidney disease should also consider other medication options since meglitinides can increase the risk of hypoglycemia in those with this condition.

Dosage

Meglitinides typically are prescribed to be taken about 15 minutes before meals three times a day. If you miss a meal, you should not take the drug. If you tend to skip meals regularly, these medications probably are not right for you.

Side Effects

Meglitinides are well-tolerated by most people, including elderly people who need help lowering their mealtime blood sugars.

Common

Low blood sugar (hypoglycemia) is the most common side effect of meglitinides. Symptoms of hypoglycemia include sweating, shakiness, lightheadedness, and confusion.

These medications also can cause weight gain.

Severe

Meglitinides are relatively short-acting, which means they're unlikely to cause hypoglycemia. However, if taken without food, these drugs can cause a significant drop in blood sugar.

Someone experiencing hypoglycemia (blood sugar less than 70mg/dL) should consume some form of glucose, such as four ounces of juice. Anyone experiencing signs of diabetic coma, including confusion or loss of consciousness, should seek medical attention immediately.

Warnings and Interactions

Meglitinides have the potential to interact with other medications. It is important for people who take them to review all of their current medications with their healthcare providers. People with diabetes should also talk to their healthcare providers before taking any over-the-counter medications or herbal supplements.