Meglitinide: Difference between revisions
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→Side effects: Added conclusions of Campbell Collaboration Systematic Review Gnesin, F., Thuesen, A. C. B., Kähler, L. K. A., Madsbad, S., & Hemmingsen, B. (2020). Metformin monotherapy for adults with type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, 2020(6). https://doi.org/10.1002/14651858.CD012906.pub2 |
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Side effects include weight gain and [[hypoglycemia]]. While the potential for hypoglycemia is less than for those on [[sulfonylurea]]s,{{cn|date=March 2021}} it is still a serious potential side effect that can be life-threatening. Patients on this medication should know the signs and symptoms of hypoglycemia and appropriate management. |
Side effects include weight gain and [[hypoglycemia]]. While the potential for hypoglycemia is less than for those on [[sulfonylurea]]s,{{cn|date=March 2021}} it is still a serious potential side effect that can be life-threatening. Patients on this medication should know the signs and symptoms of hypoglycemia and appropriate management. |
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Repaglinide caused an increased incidence in male rats of benign adenomas (tumors) of the thyroid and liver.<ref name="repaglinide">[http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020741s038lbl.pdf Prandin (repaglinide) prescribing information], fda.gov</ref> No such effect was seen with another drug of this class, nateglinide.<ref name="nateglinide">[http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021204s011lbl.pdf Starlix (nateglinide) prescribing information], fda.gov</ref> |
Repaglinide caused an increased incidence in male rats of benign adenomas (tumors) of the thyroid and liver.<ref name="repaglinide">[http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020741s038lbl.pdf Prandin (repaglinide) prescribing information], fda.gov</ref> No such effect was seen with another drug of this class, nateglinide.<ref name="nateglinide">[http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021204s011lbl.pdf Starlix (nateglinide) prescribing information], fda.gov</ref> |
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A 2020 Cochrane systematic review did not find enough evidence of reduction of all-cause mortality, serious adverse events, cardiovascular mortality, non-fatal [[myocardial infarction]], non-fatal [[stroke]] or [[Chronic kidney disease|end-stage renal disease]] when comparing [[metformin]] monotherapy to meglitinide for the treatment of type 2 diabetes.<ref>{{Cite journal |last=Gnesin |first=Filip |last2=Thuesen |first2=Anne Cathrine Baun |last3=Kähler |first3=Lise Katrine Aronsen |last4=Madsbad |first4=Sten |last5=Hemmingsen |first5=Bianca |date=2020-06-05 |editor-last=Cochrane Metabolic and Endocrine Disorders Group |title=Metformin monotherapy for adults with type 2 diabetes mellitus |url=http://doi.wiley.com/10.1002/14651858.CD012906.pub2 |journal=Cochrane Database of Systematic Reviews |language=en |volume=2020 |issue=6 |doi=10.1002/14651858.CD012906.pub2 |pmc=PMC7386876 |pmid=32501595}}</ref> |
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== Mechanism of action == |
== Mechanism of action == |
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Revision as of 05:17, 5 October 2022
| Meglitinide | |
|---|---|
| Drug class | |
 Meglitinide, the prototype of this drug class | |
| Class identifiers | |
| Use | Type 2 diabetes |
| ATC code | A10BX |
| Mode of action | insulin secretagogue (release stimulator) |
| Mechanism of action | close potassium channels of beta cells |
| Clinical data | |
| Drugs.com | Drug Classes |
| Legal status | |
| In Wikidata | |
Meglitinides or glinides are a class of drugs used to treat type 2 diabetes.[1]
Drugs
Repaglinide (trade name Prandin)[2] gained US Food and Drug Administration approval in 1997.
Other drugs in this class include nateglinide (Starlix)[3] and mitiglinide (Glufast).
Side effects
Side effects include weight gain and hypoglycemia. While the potential for hypoglycemia is less than for those on sulfonylureas,[citation needed] it is still a serious potential side effect that can be life-threatening. Patients on this medication should know the signs and symptoms of hypoglycemia and appropriate management.
Repaglinide caused an increased incidence in male rats of benign adenomas (tumors) of the thyroid and liver.[2] No such effect was seen with another drug of this class, nateglinide.[3]
A 2020 Cochrane systematic review did not find enough evidence of reduction of all-cause mortality, serious adverse events, cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke or end-stage renal disease when comparing metformin monotherapy to meglitinide for the treatment of type 2 diabetes.[4]
Mechanism of action
They bind to an ATP-dependent K+ (KATP) channel on the cell membrane of pancreatic beta cells in a similar manner to sulfonylureas but have a weaker binding affinity and faster dissociation from the SUR1 binding site. This increases the concentration of intracellular potassium, which causes the electric potential over the membrane to become more positive. This depolarization opens voltage-gated Ca2+ channels. The rise in intracellular calcium leads to increased fusion of insulin granula in the cell membrane, and therefore increased secretion of (pro) insulin.
References
- ^ Blicklé JF (April 2006). "Meglitinide analogues: a review of clinical data focused on recent trials". Diabetes Metab. 32 (2): 113–20. doi:10.1016/S1262-3636(07)70257-4. PMID 16735959.
- ^ a b Prandin (repaglinide) prescribing information, fda.gov
- ^ a b Starlix (nateglinide) prescribing information, fda.gov
- ^ Gnesin, Filip; Thuesen, Anne Cathrine Baun; Kähler, Lise Katrine Aronsen; Madsbad, Sten; Hemmingsen, Bianca (2020-06-05). Cochrane Metabolic and Endocrine Disorders Group (ed.). "Metformin monotherapy for adults with type 2 diabetes mellitus". Cochrane Database of Systematic Reviews. 2020 (6). doi:10.1002/14651858.CD012906.pub2. PMC 7386876. PMID 32501595.
{{cite journal}}: CS1 maint: PMC format (link)
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