Meglitinides

Meglitinides are a class of medications that help treat Type 2 diabetes by stimulating your pancreas to make more insulin. You take them shortly before meals to help manage blood sugar spikes. They come as tablets that you swallow. Meglitinides work quickly. Their effect wears off within a few hours. Repaglinide and nateglinide are the only FDA-approved meglitinides.

How do meglitinides work?

Meglitinides work by helping your pancreas release insulin. Insulin is the main hormone that lowers blood sugar. It serves as a key to help glucose in your blood get into your cells. This allows the cells to use that glucose for energy. Meglitinides act directly on the beta cells in the pancreas that make insulin. These drugs cause more insulin to be released into the bloodstream.

If you have Type 2 diabetes, it’s common to have spikes in blood sugar after you eat. This is especially true when the meal includes carbohydrates. Meglitinides help prevent a blood sugar spike by helping your pancreas release insulin before you start eating.

What are examples of meglitinides?

Types of meglitinides include:

• Repaglinide (Prandin®): Comes in 0.5 milligrams (mg), 1 mg or 2 mg tablets
• Nateglinide (Starlix®): Comes in 60 mg and 120 mg tablets

You take both medications before meals (up to 30 minutes before). They work quickly to lower your blood glucose. They’re cost-effective when you take them with every meal you eat. You can take them up to three times per day (once each meal).

Talk to your healthcare provider if you still have blood sugar spikes after meals. They can adjust your dosage or find a better treatment option for you.

What are the risks and side effects?

Some possible side effects of taking these medications are:

• Weight gain
• Lower blood sugar (hypoglycemia)

Taking meglitinides can increase your risk of low blood sugar episodes. Talk to your healthcare provider about signs to look out for and how to treat low blood sugar.

Repaglinide can also increase your risk of liver damage.

What are the benefits of meglitinides?

There are a few key benefits:

• Fast-acting: They work quickly. You can take a tablet before you eat a meal, and it will prevent a blood sugar spike.
• Flexible: If you skip a meal, you don’t need to take a pill. You may like this flexibility.
• Lower risk of low blood sugar: Since they wear off quickly, you’re less likely to have hypoglycemia (low blood sugar) compared to other types of Type 2 diabetes medications, like insulin or sulfonylureas.

Another benefit is that you can take meglitinides with metformin and many other diabetes medications.

Who shouldn’t take meglitinides?

You shouldn’t take them if you:

• Have Type 1 diabetes
• Already take diabetes medications like sulfonylureas that work in the same way
• Have kidney or liver disease

Be sure to tell your healthcare provider your full medical history. This includes any other medications and supplements you take.

Are meglitinides and sulfonylureas the same?

No, they’re different. Both work by stimulating your pancreas to make insulin. Meglitinides act more quickly, while sulfonylureas release insulin more slowly. You shouldn’t take them together.