Related Experiment Video
Updated: May 30, 2026
10:03
A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
Published on: February 28, 2013
Quo vadis nateglinide? Ten-year perspective.
1Grunberger Diabetes Institute, 43494 Woodward Avenue, Bloomfield Hills, MI 48302, USA. grunberger@gdi-pc.com
Expert Opinion on Pharmacotherapy
|August 2, 2011
Summary
Reducing postprandial glucose spikes with nateglinide aims to improve glycemic control in type 2 diabetes. However, current evidence does not support improved long-term outcomes with this approach.
Area of Science:
- Endocrinology
- Pharmacology
- Metabolic Diseases
Background:
- Type 2 diabetes management often involves controlling postprandial glucose spikes.
- Nateglinide, a meglitinide class agent, targets postprandial insulin secretion.
- Reviewing nateglinide's efficacy is timely given its decade-long market presence.
Purpose of the Study:
- To review preclinical and clinical research on nateglinide.
- To assess nateglinide's impact on postprandial hyperglycemia and patient outcomes.
Main Methods:
- Literature search of preclinical and clinical studies (1995-2011).
- Included PubMed database and author's article collection.
- Focused on English-language publications.
Main Results:
- Preclinical and human research data for nateglinide were promising.
- No accumulated evidence demonstrates improved outcomes for type 2 diabetes patients using nateglinide to manage postprandial hyperglycemia.
Conclusions:
- Controlling postprandial glucose excursions is important in type 2 diabetes.
- Nateglinide has not shown evidence of improving long-term outcomes.
- Further research may be needed to clarify the role of targeting postprandial hyperglycemia.
Related Concept Videos
01:06Oral Hypoglycemic Agents: Glinides
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...
01:26Oral Hypoglycemic Agents: Biguanides and Glitazones
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
01:24Glucagon-like Receptor Agonists
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by the...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by the...
01:23Dipeptidyl Peptidase 4 Inhibitors
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a significant...
01:16Insulin: Dosing Regimen and Adverse Effects
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
01:15Diabetes: Management and Pharmacotherapy
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...