Repaglinide: a new short-acting insulinotropic agent for the treatment of Type 2 diabetes

Repaglinide, a carbamoylmethyl benzoic acid derivative, is rapidly absorbed , metabolized by the liver and eliminated primarily via the bile. It has a short duration of action and is taken immediately before each main meal. Th is regimen has been shown to provide superior glycaemic control compared wi th regular morning and evening dosing. A flexible preprandial only dosing r egimen of repaglinide significantly lowers the risk of hypoglycaemia if a m eal is missed or postponed. Combination therapy with metformin improves gly caemic control significantly compared with therapy with either drug alone i n overweight patients. Repaglinide has an equivalent safety and efficacy pr ofile to the sulphonylureas, although it is superior to glipizide in mainta ining long-term glycaemic control The postprandial glucose levels are signi ficantly lower with repaglinide compared with glibenclamide. In naive patie nts with Type 2 diabetes, repaglinide lowers fasting glucose concentrations and functions also as a prandial glucose regulator.