Flexible Meal-Related Dosing With Repaglinide Facilitates Glycemic Control in Therapy-Naive Type 2 Diabetes

Moses, Robert G.; Gomis, Ramón; Frandsen, Kirstine Brown; Schlienger, Jean-Louis; Дедов, И И

doi:10.2337/diacare.24.1.11

Cited by 60 publications

(22 citation statements)

References 14 publications

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“…In contrast to those receiving longer-acting insulin secretagogues such as sulfonylureas, patients treated with repaglinide are free to vary their meal pattern from two to four main meals daily and are also able to vary the timing of meals without impairing efficacy or augmenting the risk of hypoglycemia (12). Previously reported studies involving placebo or sulfonylureas as comparators have established the efficacy of repaglinide in improving glycemic control as being at least equivalent to that of conventional oral hypoglycemic agents (13,14).…”

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confidence: 99%

Optimizing Insulin Secretagogue Therapy in Patients With Type 2 Diabetes

et al. 2002

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OBJECTIVE -Repaglinide, a novel antidiabetic agent that has a rapid onset and short duration of action, was developed for mealtime dosing. The purpose of this pharmacodynamic study was to validate a prandial regimen of repaglinide by comparing meal-related dosing with a regimen in which the same total daily dose was divided into only two doses at morning and evening meals. RESEARCH DESIGN AND METHODS -The study was a double-blind, randomized, parallel-group trial in 19 antidiabetic agent-naive subjects with type 2 diabetes (mean age 58 years, known duration of diabetes 3.5 years, HbA 1c 7.3%, and BMI 32 kg/m 2 ). Patients were randomly assigned to receive repaglinide either before each of the three main meals or before breakfast and before the evening meal. Patients in both groups received the same total daily dose of repaglinide. Twenty-four hour profiles of blood glucose, plasma insulin, and plasma Cpeptide concentrations were measured at baseline and after 4 weeks of treatment.RESULTS -Repaglinide increased postprandial insulin levels and markedly reduced postprandial glucose levels relative to baseline in both groups. Significant reductions were also recorded in fasting blood glucose and HbA 1c levels. The repaglinide regimen, in which a dose was taken before each main meal, was more effective in improving glycemic control (including postprandial glucose and HbA 1c levels) than the same total dose of repaglinide divided into morning and evening mealtime doses.CONCLUSIONS -These data support the strategy of mealtime dosing with repaglinide. The improvements in glycemic control observed in these patients are encouraging. In addition to classic parameters of glycemic control, improvements in postprandial glucose excursions may prove to be important because postprandial hyperglycemia has been suggested to be an independent risk factor for cardiovascular disease in diabetes. Diabetes Care 25:342-346, 2002T ype 2 diabetes is characterized by impaired insulin secretion, usually with concomitant impaired insulin sensitivity (1,2). Insulin secretagogue therapy is therefore a logical part of therapy of type 2 diabetes when diet and lifestyle modifications fail. Secretagogue therapy is the appropriate means to augment circulating insulin levels in patients with a moderate degree of ␤-cell dysfunction; in individuals with more advanced ␤-cell dysfunction, exogenous insulin therapy may be necessary.Sulfonylureas have been used for almost five decades as insulin secretagogues in the management of type 2 diabetes. Sulfonylureas stimulate insulin secretion and thereby reduce hyperglycemia, with few side effects. Nevertheless, the long plasma half-life and the long-lasting effect of some sulfonylureas increase the risk of hypoglycemia, especially in elderly patients and in patients with renal insufficiency (3-5). As the need to achieve nearnormoglycemia becomes recognized in the light of the findings of large prospective studies, hypoglycemia is likely to become an increasingly common feature of type 2 diabetes (6,7). In add...

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confidence: 99%

Optimizing Insulin Secretagogue Therapy in Patients With Type 2 Diabetes

et al. 2002

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“…23 In a study performed mainly in Caucasians, treatment with repaglinide (0.5-1.0 mg/meal) for 4 months significantly improved glycaemic control compared with baseline values and placebo, reducing the mean HbA 1c level by 1.1%. 24 Following the present study, the authors plan to evaluate the efficacy and safety of repaglinide administered two or three times daily at doses > 0.25 mg. In the present study, repaglinide therapy was as effective as results reported for glimepiride or glibenclamide therapy, [25][26][27] therefore, we also hope to evaluate the effectiveness of a two-or three-times-daily repaglinide regimen after switching from sulphonylurea treatment.…”

Section: Discussionmentioning

confidence: 99%

Effect of repaglinide, administered two or three times daily for 3 months, on glycaemic control in Japanese patients with type 2 diabetes mellitus

Kono

Aoki

Nakajima³

et al. 2014

J Int Med Res

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Objectives: To compare the efficacy, safety and compliance of repaglinide, administered either two or three times daily, regarding glycaemic control in patients with type 2 diabetes mellitus. Methods: Japanese adults with type 2 diabetes mellitus, who had been treated without sulphonylureas or glinides for >3 months, were randomly assigned to two groups to receive either 0.25 mg repaglinide, oral, twice daily (group A) or 0.25 mg repaglinide, oral, three times daily (group B). Glycosylated haemoglobin (HbA 1c ), glycoalbumin (GA) and 1,5-anhydroglucitol (1,5-AG) levels were measured at 0, 1, 2 and 3 months after treatment commenced. Results: Out of 43 patients who enrolled (group A, n ¼ 22; group B, n ¼ 21), 33 patients completed the trial (group A, n ¼ 16; group B, n ¼ 17). No significant between-group differences in HbA 1c , GA, or 1,5-AG levels were seen at 1-3 months. No severe hypoglycaemic episodes or other adverse events were observed. Conclusions: Minimal-dose repaglinide administered twice daily was similar in efficacy and safety to three-times-daily administration, in Japanese patients with type 2 diabetes mellitus. Administration of repaglinide twice daily could be an alternative regimen for patients who cannot take repaglinide three times daily.

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“…The maximum dose should not exceed 4 mg before each meal; the dose should be skipped if the meal is missed [93]. Hypoglycaemia is the most common side-effect [94]. Natiglinide Natiglinide (Starlix) is a very short-acting glucose-lowering drug which appears to have its effect on the fi rst phase of insulin release rather than the late phase of insulin release [95].…”

Section: Repaglinidementioning

confidence: 99%