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Related Experiment Videos

Repaglinide versus nateglinide monotherapy: a randomized, multicenter study.

Julio Rosenstock1, David R Hassman, Robert D Madder

  • 1Dallas Diabetes and Endocrine Center, 7777 Forest Lane, Suite C618, Dallas, TX 75230, USA. juliorosenstock@dallasdiabetes.com

Diabetes Care
|May 27, 2004
PubMed
Summary
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Repaglinide monotherapy significantly improved HbA1c and fasting plasma glucose (FPG) in type 2 diabetes patients compared to nateglinide. Repaglinide showed greater efficacy in reducing glycemic levels over 16 weeks.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Metabolic Disorders

Background:

  • Type 2 diabetes mellitus (T2DM) management requires effective glycemic control.
  • Oral hypoglycemic agents play a crucial role in T2DM treatment.
  • Repaglinide and nateglinide are meglitinide analogs used to manage blood glucose levels.

Purpose of the Study:

  • To compare the efficacy and safety of repaglinide monotherapy versus nateglinide monotherapy in T2DM patients previously treated with diet and exercise.
  • To evaluate the impact of these medications on HbA1c, fasting plasma glucose (FPG), and postprandial glucose levels.

Main Methods:

  • A 16-week, randomized, parallel-group, open-label, multicenter clinical trial.
  • 150 T2DM patients with HbA1c between 7% and 12% were randomized to receive either repaglinide (n=76) or nateglinide (n=74) monotherapy.

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  • Primary endpoint: change in HbA1c; Secondary endpoint: change in FPG. Postprandial glucose, insulin, and glucagon were also assessed.

    • Main Results:

    • Both repaglinide and nateglinide showed similar postprandial glycemic effects.
    • Repaglinide monotherapy resulted in significantly greater reductions in HbA1c (mean -1.57% vs. -1.04%) and FPG (mean -57 mg/dl vs. -18 mg/dl) compared to nateglinide.
    • 54% of repaglinide-treated patients achieved HbA1c <7% versus 42% for nateglinide.
    • Minor hypoglycemia occurred in 7% of repaglinide patients, with no episodes in the nateglinide group. Mean weight gain was higher with repaglinide (1.8 kg) than nateglinide (0.7 kg).

    Conclusions:

    • Repaglinide monotherapy demonstrated superior efficacy over nateglinide monotherapy in reducing HbA1c and FPG levels in T2DM patients after 16 weeks.
    • While both agents have similar postprandial effects, repaglinide offers a more significant overall glycemic control improvement.
    • Safety profiles were generally acceptable, with minor hypoglycemia noted in the repaglinide group.