Meglitinide

Meglitinides, aka "Glinides"^[1], are a class of drugs used treat diabetes type 2.

They bind to an ATP-dependent K⁺ (K_ATP) channel on the cell membrane of pancreatic beta cells in a similar manner to sulfonylureas but at a separate binding site. This inhibits a tonic, hyperpolarizing outflux of potassium, which causes the electric potential over the membrane to become more positive. This depolarization opens voltage-gated Ca²⁺ channels. The rise in intracellular calcium leads to increased fusion of insulin granulae with the cell membrane, and therefore increased secretion of (pro)insulin.

Drugs

The main branded drug in the meglitinide class is Novo Nordisk's repaglinide (Prandin), which gained FDA approval in 1997. Another type of drug in this class is nateglinide (Starlix).

These drugs should be taken 0-30 minutes prior to eating. Follow the instructions given to you by your health-care provider.

Side-effects

Side effects include weight gain and hypoglycemia. While the potential for hypoglycemia is less than for those on sulfonylureas, it is still a serious potential side effect that can be life-threatening. Patients on this medication should know the signs and symptoms of hypoglycemia and appropriate management.

Repaglinide (Prandin) caused an increased incidence in male rats of benign adenomas (tumors) of the thyroid and liver. No such effect was seen with the other drug of its class nateglinide (Starlix).

http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020741s038lbl.pdf

http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021204s011lbl.pdf

References