Meglitinides

Meglitinides, such as Prandin and Starlix, help control Type 2 diabetes by enhancing insulin production in response to high blood glucose levels. Unlike the sulfonylureas, whose effects last a full day, increasing risk of low blood sugar episodes, the meglitinides act over a three hour period, so they act only during the post-meal blood sugar spike period. Both Prandin and Starlix are taken before meals.

Since meglitinides work by enhancing insulin production, they cannot be used by Type 1 diabetics, or Type 2 diabetics whose beta cells have stopped producing insulin. However, in individuals who can produce insulin, meglitinides can be combined with basal insulin such as NPH, Detemir, or Lantus, to provide insulin function much like that of a normal, non-diabetic. The basal insulin control fasting blood sugar levels, while the meglitinide mimics a non-diabetic’s post-meal first phase insulin release.

If you’re interested in whether or not meglitinides can help manage your diabetes, monitor your blood sugar one or two hours after each meal, and see if your blood sugar consistently spikes 40-50mg/dl after you eat. If so, and if your body is still able to produce insulin, this class of medication may be a great benefit to you. If your blood sugar tends to maintain a relatively high level, without a specific short-term spike after a meal, the longer-acting sulfonylureas may be more appropriate. Consult with your doctor about your after-meal blood sugar test results.

People with impaired liver function should generally not take meglitinides, and both Starlix and Prandin have interactions with a significant number of other medications, ranging from many medications that can enhance the effect of the meglitinides (potentially causing hypoglycemic episodes) to many others that may impair the function of these diabetic medications, requiring adjusted doses or possibly use of different medications altogether.



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