Effects of Nateglinide on the Elevation of Postprandial Remnant-like Particle Triglyceride Levels in Japanese Patients with Type 2 Diabetes Assessment by Meal Tolerance Test

Mori, Yutaka; Kuriyama, Genshin; Tajima, Naoko

doi:10.1385/endo:25:3:203

Cited by 9 publications

(4 citation statements)

References 19 publications

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“…17,18 The clinical effects of nateglinide, which also produces rapid insulin secretion, on post-prandial hyperlipidaemia have been reported. 19 No statistically significant changes in fasting total cholesterol, triglyceride, HDLcholesterol or FFAs were observed after 12 months of treatment with mitiglinide in the present study, whereas there was a statistically significant decrease in 60-min post-prandial FFAs, suggesting that this drug may reduce lipotoxicity. FFAs may cause or aggravate type 2 diabetes mellitus and metabolic syndrome via inhibition of insulin action in insulin-sensitive organs such as a Multiple regression analysis was performed in order to assess the combined influence of variables on changes in levels of 60-min post-prandial free fatty acids in patients with type 2 diabetes mellitus treated with mitiglinide for 12 months.…”

Section: Discussioncontrasting

confidence: 72%

Pleiotropic Effects of Mitiglinide in Type 2 Diabetes Mellitus

et al. 2009

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This study investigated the effects of mitiglinide in 16 patients with type 2 diabetes mellitus treated with 30 mg/day mitiglinide, divided into three doses given just before each meal, for approximately 12 months. A 450 kcal meal tolerance test was performed at baseline and after 3, 6 and 12 months, and levels of plasma glucose and immunoreactive insulin were measured. Various parameters of glucose metabolism and lipid metabolism, urinary albumin and markers of atherosclerosis, coagulation and fibrinolysis were also determined. Mitiglinide showed a rapid stimulatory effect on insulin secretion and reduced the levels of plasma glucose. The free fatty acid level significantly decreased at 60 min after the meal tolerance test. Mitiglinide also significantly lowered glycosylated haemoglobin and raised 1,5-anhydroglucitol after 6 months, and significantly decreased urinary albumin after 12 months. These data indicate that mitiglinide may have beneficial effects not only on glycaemic control but also on lipid metabolism and urinary albumin excretion, and may have a role in the prevention of the vascular complications of diabetes.

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Section: Discussioncontrasting

confidence: 72%

Pleiotropic Effects of Mitiglinide in Type 2 Diabetes Mellitus

et al. 2009

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“…acarbose, insulin, rosiglitazone and nateglinide) on postprandial hypertriglyceridaemia [186,[255][256][257][258][259]. A detailed discussion of these drugs is beyond the scope of the present review.…”

Section: Drugs Used To Treat Diabetes Mellitusmentioning

confidence: 92%

Clinical Relevance of Postprandial Lipaemia

Kolovou¹,

Anagnostopoulou²,

Daskalopoulou³

et al. 2005

CMC

115

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Several studies showed that after a fatty meal, plasma triglyceride (TG) levels are higher in patients with coronary heart disease. This abnormality may explain why some individuals develop atherosclerotic disease despite normal fasting lipid values. TG-rich lipoproteins are involved in atherosclerosis and thrombosis. TG, remnant-like particle (RLP) cholesterol (RLP-C) and RLP-TG increase after fat load and could contribute to atherothrombosis. Postprandial lipaemia is not a uniform abnormality. Its pathophysiology is not yet entirely clarified; possibly, the response to dietary fat is a polygenic phenomenon. However, a link with insulin resistance is likely; this link as well as that with obesity is discussed. A substantial part of life is spent in the postprandial state. Therefore, several investigators described fat load tests. However, it is still difficult to establish normal postprandial TG ranges since only small numbers of subjects were studied and there is as yet no standardised method. A more simplified fat load test should be established for 'routine' use. In this review, we consider the metabolic features, prevalence and management of postprandial lipaemia. Treatment may involve lifestyle measures as well as the use of lipid lowering (e.g. fibrates or statins), weight reducing and hypoglycaemic drugs.

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“…Furthermore, chronic nateglinide administration reduced hepatic triglyceride accumulation in diabetic rats fed on a high‐fat diet, perhaps via an effect on lipid oxidation or lipogenesis (50). Administration of a single (90 mg) dose of nateglinide significantly reduced postprandial levels of triglycerides and remnant‐like particles in drug‐naïve Japanese individuals with type 2 diabetes (51). Other data indicate that the suppression of postprandial non‐esterified fatty acid levels during acute and chronic treatment with nateglinide (120 mg t.i.d.)…”

Section: Human Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

Nateglinide - current and future role in the treatment of patients with type 2 diabetes mellitus

Campbell¹

2005

International Journal of Clinical Practice

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Therapy for type 2 diabetes mellitus should aim to control not only fasting, but also postprandial glucose levels. Nateglinide, a d-phenylalanine derivative, restores postprandial early phase insulin secretion in a transient and glucose-sensitive manner without affecting basal insulin levels. As nateglinide is administered immediately before meals it provides greater lifestyle flexibility than agents that require patients to eat to avoid hypoglycemic events (e.g. long-acting sulfonylureas). In randomised, double-blind trials in patients with type 2 diabetes, nateglinide monotherapy (mealtime treatment of 120 mg three times daily) significantly improved long-term glycaemic control by significantly reducing glyated haemoglobin (HbA 1c) and preventing mealtime glucose spikes. The combination of nateglinide with insulin-sensitising agents, for example, metformin and thiazolidinediones, addresses the dual defects of loss of insulin secretion and insulin resistance to provide optimal management of type 2 diabetes, and more patients achieve HbA 1c goal with nateglinide combination therapy rather than with monotherapy with other oral agents. Nateglinide also restores early insulin secretion and reduces postprandial hyperglycaemia in prediabetic subjects with impaired glucose tolerance (IGT) and appears similarly effective in elderly and non-elderly populations with type 2 diabetes. It has an excellent safety and tolerability profile, with a low propensity to cause hypoglycaemia due to its transient, selective effect on early phase insulin secretion. Nateglinide as monotherapy or combination therapy is an effective option to reduce mealtime glucose in patients with type 2 diabetes. The results of ongoing research into its potential role in delaying progression to overt diabetes, and protecting against cardiovascular events, in prediabetic patients with IGT are awaited.

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Effects of Nateglinide on the Elevation of Postprandial Remnant-like Particle Triglyceride Levels in Japanese Patients with Type 2 Diabetes Assessment by Meal Tolerance Test

Cited by 9 publications

References 19 publications

Pleiotropic Effects of Mitiglinide in Type 2 Diabetes Mellitus

Pleiotropic Effects of Mitiglinide in Type 2 Diabetes Mellitus

Clinical Relevance of Postprandial Lipaemia

Nateglinide - current and future role in the treatment of patients with type 2 diabetes mellitus

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