Meglitinides: Oral Medication for Type 2 Diabetes

holding a pill

Meglitinides are oral medications used in the treatment of type 2 diabetes. Medications in this class include Prandin (repaglinide) and Starlix (nateglinide).

What Meglitinides Do

In the human body, insulin is produced by specialized cells in the pancreas. These are called beta cells. In people with type 2 diabetes, either the pancreas isn't producing enough insulin or the insulin it is making is not being used efficiently, which make blood sugar levels harder to control.

Meglitinides stimulate the beta cells to produce more insulin, helping the body to better process glucose (sugar) and to lower blood sugar levels. This particular class of medication is meant to help lower blood sugars after meals.

Meglitinides are relatively short-acting medications which means that they have a lower risk of producing hypoglycemia. However, if this medication is taken without food it can cause low blood sugars.

Also, meglitinides should be taken about 15 minutes prior to a meal and are typically prescribed to be used three times daily before meals. If you skip a meal, you should not take it. The timing of the medication can allow for more flexible meal planning since they are only taken when you are eating. 

What Meglitinides Do Not Do

While meglitinides help produce more insulin in patients who still produce some from the pancreas, they do not directly reduce blood sugar. Therefore, meglitinides are not a substitute for insulin and are not appropriate for patients with type 1 diabetes. Meglitinides should always be taken in conjunction with lifestyle changes, such as diet and exercise.

History of Meglitinides

Meglitinides have been approved by the FDA for the treatment of type 2 diabetes since 1997. They can be used alone or in combination with other medications. This class of medication is tolerated well in the elderly who need help lowering their mealtime blood sugars. Meglitinides can also be expensive.

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

Who Should Not Use Meglitinides

People with type 1 (insulin-dependent) diabetes or allergies to meglitinides should not use them. Patients currently experiencing physical stress caused by infection, injury, or surgery may need to temporarily stop taking meglitinides.

In addition, meglitinides must be taken only with food. If a person misses a meal, he or she should skip a dose.

Side Effects and Risks of Meglitinides

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

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 immediate medical attention immediately. Meglitinides can also cause weight gain

What Else Should I Know?

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 health care providers first.

People with diabetes should also talk to their healthcare providers before taking any over-the-counter medications or herbal supplements. If you are a person that tends to skip meals regularly, then this medication is probably not right for you, too. 

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Article Sources
  • Bolen, Shari. "Systematic Review: Comparative Effectiveness and Safety of Oral Medications for Type 2 Diabetes Mellitus." Annals of Internal Medicine 147

  • Bolen, Shari, et al. "Comparative effectiveness and safety of oral medications for adults with type 2 diabetes." Agency for Healthcare Research and Quality: Reports. 15 Jul 2007. U.S. Department of Health and Human Services.

  • McCullouch, David K. "Sulfonylureas and Meglitinides in the Treatment of Diabetes Mellitus." 2007. UpToDate. (subscription) .