Meglitinides

Research compares health outcomes in four insulin regimens.

David Levy, MD, FRCP Introduction The pharmacological management of blood glucose in type 2 diabetes remains the most contentious area of diabetes management, and although until relatively recently in the USA the only agents to treat blood glucose were insulin and sulphonylureas, this limited repertoire in no way inhibited the controversy, …

David Levy, MD, FRCP INTRODUCTION There has been a recent resurgence of interest in the management of diabetes in hospitalized patients. Guidelines in the USA are well-established, and in the UK the ‘ThinkGlucose’ campaign has highlighted the importance of good diabetes care in hospital. Note that good diabetes care does not …

A large database analysis has found that two oral diabetes drug classes, thiazolidinediones (TZDs) and sulfonylureas, both increase the risk for fractures when compared with metformin…. 

Richard S. Beaser, MD Medications that Increase Insulin Secretion: SULFONYLUREAS CLASS SUMMARY: Action: Insulin secretagogues. Initial effects are to increase insulin secretory capacity. With establishment of long-term glucose control, this increase may not persist and other extrapancreatic effects, either direct or indirect, may also occur. Required for efficacy: Some remaining …

Richard S. Beaser, MD This week’s excerpt covers the following topics: Which medications slow glucose absorption? Which medications increase insulin secretion? What is first phase insulin response? Who are the patient candidates for the different drug classes? Nateglinide vs. Repaglinide  

Richard S. Beaser, MD This week’s excerpt covers the following topics: The mechanism of action for antidiabetes medications Which medications improve insulin action Which meds slow gastric absorption Which meds increase insulin secretion Which meds increase the effect of incretins How to compare diabetes meds  

Treatment of type 2 diabetes (T2DM) Education of patients is very important The importance of diet and exercise should be emphasized All patients should be reviewed by a dietitian for appropriate advice Measures to induce weight loss (most of these patients are overweight) should be encouraged/implemented In the initial phases …

Richard S. Beaser, MD This week’s excerpt covers the following topics: Knowing the options for treatment Determining medication selection Clinical markers for the dominant underlying pathophysiology The three stages to glucose patterns

Stavros Liatis, Nikolaos Katsilambros           Sulfonylureas and non-sulfonylurea insulin secretagogues (meglitinides) exert their antidiabetic effects by binding to the sulfonylurea receptor (SUR) on the beta-cell, which regulates the activity of an ATP-dependent potassium channel.1