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Related Concept Videos

Oral Hypoglycemic Agents: Glinides01:06

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Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...
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Hypersensitivity to repaglinide.

P Rojas1, L Sánchez, A Santos

  • 1Allergy Unit, Hospital Central de la Cruz Roja, Madrid, Spain. projasperezezquera@seaic.org

Journal of Investigational Allergology & Clinical Immunology
|May 10, 2011
PubMed
Summary
This summary is machine-generated.

Hypersensitivity to repaglinide, an insulin secretagogue for diabetes, can manifest as a delayed skin rash. This case highlights a potential type IV hypersensitivity reaction to repaglinide.

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Area of Science:

  • Clinical Immunology
  • Dermatology
  • Endocrinology

Background:

  • Meglitinides, including repaglinide and nateglinide, are oral hypoglycemic agents stimulating insulin secretion.
  • These drugs are commonly prescribed for managing type 2 diabetes mellitus.

Observation:

  • A 61-year-old male patient developed a maculopapular rash five days after initiating repaglinide therapy.
  • Standard skin tests (prick and patch) for repaglinide allergy were negative.
  • A delayed cutaneous reaction occurred on day 3 of a blind oral challenge test with repaglinide.

Findings:

  • Skin biopsy confirmed drug-induced exanthema.
  • The clinical presentation, delayed onset, and recurrence upon rechallenge suggest a hypersensitivity reaction.
  • Histopathology and clinical course indicate a probable type IV (delayed) hypersensitivity mechanism.

Implications:

  • This case underscores the importance of considering delayed hypersensitivity reactions to meglitinides, even with negative initial skin tests.
  • Type IV hypersensitivity should be suspected in patients presenting with unexplained skin rashes during repaglinide treatment.
  • Further investigation into specific diagnostic markers for meglitinide-induced delayed hypersensitivity may be warranted.