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Nateglinide + Metformin = 1.4% Decrease in A1c

This published results are from last year, but still very few patients have been put on the combination The combination of the investigational drug nateglinide with metformin has been shown to help control blood glucose levels among subjects with type 2 diabetes.

Study data showed that when nateglinide was combined with metformin, glycosylated hemoglobin A (HbA1c) levels decreased by 1.4% from baseline. Nateglinide monotherapy decreased HbA1c levels by 0.5% from baseline, while metformin alone decreased subjects’ HbA1c by 0.8%, the researchers said.

"What nateglinide does is restore the first phase of insulin secretion, which is lost in people with type 2 diabetes. In the study of 685 patients with type 2 diabetes, nateglinide reduced mealtime glucose spikes by increasing early phase insulin secretion. Metformin reduced fasting plasma glucose levels by reducing glucose production, and thereby improved insulin sensitivity.

When taken before a meal, nateglinide kicks out insulin very quickly, so blood sugar levels don’t jump up abruptly. When nateglinide was taken with metformin, the combination of agents lowered the risk of postprandial hypoglycemia.

Subjects in the 24-week, randomized, double-blind, placebo-controlled study were given nateglinide (120 mg before three meals) in comparison or in combination with metformin (500 mg with three meals). Fasting plasma glucose levels decreased 0.7 mM with nateglinide, 1.6 mM with metformin and 2.4 mM with the combination of the two agents, compared with baseline.

Nateglinide, "represents a new class of drugs that stimulate insulin release from the pancreas at mealtimes, Is now available from Novartis as Starlix® Glucophage (metformin) is now available as a generic version for a 70% savings.