‫‪Meglitinide‬‬

‫اﻋ د اد اﻟطﻼ ب ‪:‬‬

‫‪ -1‬ﺣﺳن اﺣﻣد‬
‫‪ -2‬اﺣﻣد ﺷرﯾف‬
‫‪ -3‬اﺣﺳﺎن ﻋﺑد اﻟرﺣﯾم‬
‫‪ -4‬دﯾﺎﻧﺎ ھزﺑر‬
‫اﺷراف ‪ :‬اﻟدﻛﺗور ﻣﺣﻣد ﻋﺎﯾد‬
Introduction:

— Meglitinides are oral medications used in

the treatment of type 2 diabetes. Medications
in this class include Prandin (repaglinide) and
Starlix (nateglinide).
— They bind to an ATP-dependent K+ (KATP)
channel on the cell membrane of pancreatic
beta cells in a similar manner to sulfonylureas
but have a weaker binding affinity and faster
dissociation from the SUR1 binding site
• This increases the concentration of
intracellular potassium, which causes the
electric potential over the membrane to
become more positive.
• This depolarization opens voltage-gated
Ca2+ channels. The rise in intracellular
calcium leads to increased fusion of insulin
granula in the cell membrane, and
therefore increased secretion of (pro)
insulin.
Uses:

• In the human body, insulin is produced by

specialized cells in the pancreas. These are
called beta cells.
• In people with type 2 diabetes, either the
pancreas isn't producing enough insulin or the
insulin it is making is not being used
efficiently. Both make blood sugar levels
harder to control.
• Meglitinides stimulate beta cells to
produce more insulin, allowing the body to
better process glucose (sugar) and lowering
blood sugar levels.
• This particular class of medication is
meant to help lower blood sugars after
meals, and is particularly helpful for those
with flexible schedules and when consistent
mealtimes aren't always possible.
• Meglitinides have been approved by the
FDA for the treatment of type 2 diabetes
since 1997.
• The first agent in this class, repaglinide,
was approved in 1997, and a second agent,
nateglinide, was approved in 2000.1 They
can be used alone or in combination with
other medications.
• This class of medication is tolerated well
in the elderly who need help lowering their
mealtime blood sugars.
Before Taking:
— While meglitinides help produce more
insulin in patients who still produce some
from the pancreas, they do not directly
reduce blood sugar.
— Therefore, meglitinides are not a
substitute for insulin and are not
appropriate for patients with type 1
diabetes.
— Meglitinides should always be taken in
conjunction with making lifestyle
changes, such as following a low-carb diet
and increasing exercise.
Precautions and
Contraindications:
• Meglitinides can cause weight gain and
can also be expensive. If cost is an issue,
ask your doctor about the older
medications sulfonylureas and metformin,
which may be equally as effective.
• Studies indicate that repaglinide is
comparable to other oral anti-diabetes
medications for lowering blood sugar.
Nateglinide, while useful, may be
somewhat less effective at lowering blood
sugar levels than other anti-diabetes
medications.2
• People with type 1 (insulin-dependent)
diabetes or allergies to meglitinides should
not use them.
• Patients currently experiencing physical
stress caused by infection, injury, or surgery
may need to temporarily stop taking
meglitinides.
• Those with kidney disease should also
consider other medication options since
meglitinides can increase the risk of
hypoglycemia in those with this condition.3
Dosage:

• Meglitinides should be taken about

15 minutes prior to a meal and are
typically prescribed to be used three
times daily before meals. If you skip a
meal, you should not take it.
• The timing of the medication can
allow for more flexible meal planning
since it is only taken when you are
eating.
How to Take and Store:

• If you are a person that tends to skip

meals regularly, then this medication is
probably not right for you, too.
• Meglitinides must be taken only with
food. If a person misses a meal, they
should skip a dose.
Side Effects:

• Common

• Low blood sugar (hypoglycemia) is the most

common side effect of meglitinides.
• Symptoms of hypoglycemia include
sweating, shakiness, lightheadedness, and
possible confusion.
— Severe
— Meglitinides are relatively short-acting
medications, which means that they have a lower
risk of producing hypoglycemia.
— However, if this medication is taken without
food, it can cause low blood sugars.
— Someone experiencing hypoglycemia (blood
sugar less than 70mg/dL) should consume some
form of glucose, such as four ounces of juice.
— Anyone experiencing signs of diabetic coma,
including confusion or loss of consciousness,
should seek medical attention immediately.
Interactions and warning :

• Meglitinides have the potential to interact

with other medications.
• It is important for people who take them to
review all of their current medications with
their health care providers.
• People with diabetes should also talk to
their healthcare providers before taking any
over-the-counter medications or herbal
supplements.
• Meglitinides are not approved for use in
pregnant or breastfeeding women, or in children.
• If you have liver or kidney disease or are
elderly, meglitinides may not be a good choice
for you.
• As with all diabetes medicines, it’s important
that you check your blood sugar levels when
taking a meglitinide. Include some before-meal
and after-meal blood sugar checks so that you
and your doctor can evaluate how well this
medicine is working for you.
Thank you