Impairment of Early Insulin Response after Glucose Load, Rather than Insulin Resistance, is Responsible for Postprandial Hyperglycemia Seen in Obese Type 2 Diabetes. Assessment Using Nateglinide, a New Insulin Secretagogue.

Uchino, Hiroshi; Niwa, Masataka; Shimizu, Tomoaki; Nishiyama, Keisuke; Kawamori, Ryuzo

doi:10.1507/endocrj.47.639

Cited by 49 publications

(40 citation statements)

References 5 publications

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“…The rapid-acting insulin secretagogues, e.g., mitiglinide and nateglinide, selectively enhance early meal-induced insulin secretion and improve mealtime glucose control when given alone or in combination with oral hypoglycemic drugs. We previously described that nateglinide improved glycemic response after oral glucose load in obese individuals with impaired glucose tolerance or early type 2 diabetes by improvement of early phase insulin secretion without increasing the total amount of insulin (i.e., area under the curve) [15,16]. While we compared the effects of a small dose of gliclazide (20 mg) with nateglinide (270 mg), the hypoglycemic effects of glicalzide are stronger though it elicited more frequent hypoglycemic episodes [17].…”

Section: Discussionmentioning

confidence: 97%

Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

et al. 2006

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Abstract. Mitiglinide is novel class of rapid-acting insulin secretagogues, which have been widely used alone or in combination with other oral hypoglycemic drugs to improve postprandial hyperglycemia in early type 2 diabetes. While mitiglinide enhances postprandial requirement of insulin, the efficacy of mitiglinide combined with insulin has yet to be established. We investigated the efficacy of mitiglinide combined with insulin glargine, the first soluble insulin analog that has a flat and prolonged effect. After control with the intensive regimen (daily aspart insulin and glargine), 30 inpatients with type 2 diabetes were switched to premeal mitiglinide combined with once daily insulin glargine (mitiglinide regimen), and daily profiles of blood glucose level were compared under each regimen. Fifteen patients showed similar control of hyperglycemia with mitiglinide regimen and intensive insulin regimen, assessed by M value (<32), while the remaining 15 showed worsening under the mitiglinide regimen. The patients who were well controlled with mitiglinide regimen were significantly younger (51.9 ± 16.0 years, p<0.005) and heavier (body mass index: 25.7 ± 3.3 kg/m 2 , p<0.05) than those who were not (67.9 ± 8.7 and 23.0 ± 3.1, respectively). Moreover, insulin doses of aspart per body weight were significantly fewer in effective group than in ineffective group. Duration of diabetes was shorter in the effective group, albeit insignificantly. Previous treatment before starting intensive insulin regimen, such as insulin and sulfonylurea, was not different between the two groups. Our results suggest that mitiglinide plus insulin glargine combination therapy is useful for lowering both fasting and postprandial hyperglycemia in a subpopulation of type 2 diabetes. The long-term effects of such treatment need to be established in future studies.

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Section: Discussionmentioning

confidence: 97%

Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

et al. 2006

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“…9) Nateglinide is a recently approved oral hypoglycemic agent of a new class, which stimulates the early phase of insulin secretion by pancreatic b-cells, 10,11) and consequently suppresses postprandial hyperglycemia in both animals and patients with type 2 diabetes. 12,13) In this study, we established postprandial hypertriglyceridemia models using two different diabetic animals, obese Zucker fatty (ZF) rats with insulin resistance and Goto-Kakizaki (GK) rats with impaired insulin secretion. Then we investigated the effects of nateglinide on plasma triglyceride levels after oral loading with fat emulsion, and compared the results with those obtained using an a-glucosidase inhibitor (voglibose) or glibenclamide.…”

mentioning

confidence: 99%

Nateglinide Suppresses Postprandial Hypertriglyceridemia in Zucker Fatty Rats and Goto-Kakizaki Rats: Comparison with Voglibose and Glibenclamide.

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Kitahara

et al. 2002

Biological & Pharmaceutical Bulletin

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“…Consistent with the more physiological nature of nateglinide, the overall insulin exposure is relatively lower than that produced by sulfonylurea medication in type 2 diabetes [14,15]. We have previously described that nateglinide improved glycemic response after oral glucose load in obese individuals with impaired glucose tolerance or early type 2 diabetes by improvement of early phase insulin secretion without increasing the total amount of insulin (i.e., area under the curve) [17,18].…”

Section: Discussionmentioning

confidence: 77%

Efficacy and Adverse Effects of Nateglinide in Early Type 2 Diabetes. Comparison with Voglibose in a Cross-over Study

et al. 2006

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Abstract. An open-label prospective cross-over trial was performed to compare the efficacy and adverse effects of nateglinide with those of voglibose on Japanese early type 2 diabetes (who were oral hypoglycemic agent naïve and whose HbA 1C levels were between 7.0 and 7.9% before treatment). Fourteen patients received 270 mg/day of nateglinide and 15 patients received 0.6 mg/day of voglibose. After 12 weeks of either therapy, the drugs were switched and treatment was continued for another 12 weeks. After 3-month treatment with each drug, HbA 1C value decreased significantly (baseline HbA 1C 7.24 ± 0.42%, 6.70 ± 0.47% with nateglinide: p<0.01, 6.93 ± 0.62% with voglibose: p<0.05) but the difference in the effect between nateglinide and voglibose was not significant (p = 0.121). Symptoms related to hypoglycemia (e.g., increased appetite, palpitation, sweating, tremor) were scarcely observed with either voglibose or nateglinide treatments. Abdominal fullness/borborygmi was frequently reported, with variable severity, by patients on voglibose but this was absent or mild in those on nateglinide. After completion of both arms of the study, more patients favored nateglinide than voglibose. Our results suggest that nateglinide is an effective and safe drug in the treatment of early type 2 diabetes, similar to voglibose.

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Impairment of Early Insulin Response after Glucose Load, Rather than Insulin Resistance, is Responsible for Postprandial Hyperglycemia Seen in Obese Type 2 Diabetes. Assessment Using Nateglinide, a New Insulin Secretagogue.

Cited by 49 publications

References 5 publications

Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

Nateglinide Suppresses Postprandial Hypertriglyceridemia in Zucker Fatty Rats and Goto-Kakizaki Rats: Comparison with Voglibose and Glibenclamide.

Efficacy and Adverse Effects of Nateglinide in Early Type 2 Diabetes. Comparison with Voglibose in a Cross-over Study

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