Repaglinide and diabetes: new preparation. No better than glucose-lowering sulphonamides

(1) In France, repaglinide is indicated for the treatment of type 2 diabetes, alone or in combination with metformin, when lifestyle measures are inadequate. (2) The clinical file on repaglinide contains no trials based on morbidity and mortality end points. (3) According to comparative trials versus glucose-lowering sulphonamides, the glucose-lowering effect of repaglinide seems to be equivalent to that of glibenclamide. (4) The adverse effect profile of repaglinide appears similar to that of glucose-lowering sulphonamides. Hypoglycaemia is the most frequent adverse effect. In comparative trials, hypoglycaemia was as frequent in patients on repaglinide as in those on glucose-lowering sulphonamides. (5) Drug interactions can occur between repaglinide and some enzyme inhibitors or inducers. (6) Treatment with repaglinide at the maximal dose recommended in France is nearly 4 times as costly as with glibenclamide at the maximal dose.