What to Know About Meglitinides

A Medication Class Used to Treat Type 2 Diabetes

Close up of someone holding a pill

solidcolours / iStockphoto

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

Uses

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. Both make blood sugar levels harder to control.

Meglitinides stimulate beta cells to produce more insulin, allowing the body to better process glucose (sugar) and 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 FDA for the treatment of type 2 diabetes since 1997. The first agent in this class, repaglinide, was approved in 1997, and a second agent, nateglinide, was approved in 2000. 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.

Before Taking

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 making lifestyle changes, such as following a low-carb diet and increasing exercise.

Precautions and Contraindications

Meglitinides can cause weight gain and can also be expensive. If cost is an issue, ask your doctor about the older medications sulfonylureas and metformin, which may be equally as effective.

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.

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. Those with kidney disease should also consider other medication options since meglitinides can increase the risk of hypoglycemia in those with this condition.

Dosage

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 it is only taken when you are eating. 

How to Take and Store

If you are a person that tends to skip meals regularly, then this medication is probably not right for you, too. Meglitinides must be taken only with food. If a person misses a meal, they should skip a dose.

Side Effects

Common

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

Severe

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.

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 health care providers. People with diabetes should also talk to their healthcare providers before taking any over-the-counter medications or herbal supplements.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. White JR. A brief history of the development of diabetes medications. Diabetes Spectr. 2014;27(2):82-6. doi:10.2337/diaspect.27.2.82

  2. Guardado-mendoza R, Prioletta A, Jiménez-ceja LM, Sosale A, Folli F. The role of nateglinide and repaglinide, derivatives of meglitinide, in the treatment of type 2 diabetes mellitus. Arch Med Sci. 2013;9(5):936-43. doi: 10.5114/aoms.2013.34991

  3. Wu PC, Wu VC, Lin CJ, et al. Meglitinides increase the risk of hypoglycemia in diabetic patients with advanced chronic kidney disease: a nationwide, population-based study. Oncotarget. 2017;8(44):78086-78095. doi:10.18632/oncotarget.17475

  4. Grant JS, Graven LJ. Progressing from metformin to sulfonylureas or meglitinides. Workplace Health Saf. 2016;64(9):433-9. doi:10.1177/2165079916644263

Additional Reading