A Perception of Anti-diabetic Drug Repaglinide: An Extended Overview

As the prevalence of type 2 diabetes continues to rise, new drug therapies will need to be explored to prevent morbidity and mortality associated with diabetes as well as growing health care costs. Type 2 diabetes mellitus is characterized by abnormal beta-cell function (present at the time of diagnosis) that is often associated with insulin resistance. Numerous oral medications are currently approved for the treatment of type 2 diabetes. A treat-to-failure approach has traditionally been adopted with step-wise additions of oral medications; however, a growing frequency of treatment failures with monotherapy has led to the use of combination therapies earlier in the treatment of type 2 diabetes. One such combination regimen is repaglinide (a prandial glucose optimizer that increases insulin release). Findings from several clinical trials have shown repaglinide therapy to be superior to either monotherapy with significant reductions in hemoglobin A1C and fasting glucose values. Repaglinide used in combination also has shown less incidence of hypoglycemia compared with other combination therapies such as sulphonylureas. When taken prior to main meals, the rapid onset and relatively short duration of action of repaglinide aid disposal of the mealtime glucose load, without continued stimulation of pancreatic beta-cells in the postprandial fasting period. Repaglinide is also characterized by hepatic metabolism and elimination, which is an advantage in the context of impaired renal function. Repaglinide therapy appears to be a valuable therapeutic option for type 2 diabetic patients seeking a less complex drug regimen