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Diabetes prevention: can insulin secretagogues do the job?

Barbara Westerhaus1, Aidar R Gosmanov, Guillermo E Umpierrez

  • 1Department of Medicine, Division of Endocrinology, Emory University School of Medicine, Atlanta, GA 30303, USA.

Primary Care Diabetes
|December 28, 2010
PubMed

Insights

Insulin secretagogues, including nateglinide, do not prevent diabetes progression in individuals with impaired glucose tolerance. A literature review found no evidence supporting their use for diabetes prevention.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Impaired glucose tolerance is a precursor to type 2 diabetes.
  • Insulin secretagogues aim to improve glycemic control by stimulating insulin release.
  • The NAVIGATOR trial evaluated nateglinide for diabetes prevention without success.

Purpose of the Study:

  • To assess the efficacy of insulin secretagogues as a class for preventing type 2 diabetes.
  • To synthesize evidence from randomized controlled studies and reviews on diabetes prevention.

Main Methods:

  • Conducted a comprehensive literature search in PubMed and Ovid Medline.
  • Included randomized controlled studies and review articles published since 1950.
  • Focused on sulfonylureas, nateglinide, and meglitinide for diabetes prevention.

Main Results:

  • Identified three relevant studies.
  • None of the reviewed studies demonstrated a significant benefit of insulin secretagogues in preventing diabetes.
  • Nateglinide failed to prevent progression from impaired glucose tolerance to diabetes in the NAVIGATOR trial.

Conclusions:

  • Insulin secretagogues are not recommended for diabetes prevention.
  • Current evidence does not support the use of this drug class for preventing type 2 diabetes.
  • Further research may be needed to explore alternative strategies for diabetes prevention.

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