Issue 97 Item 11 Repaglinide Best at Mealtimes Three Times a Day, not Twice

Repaglinide Best at Mealtimes Three Times a Day, not Twice A group of researchers led by Dr Schmitz from the University Hospital of Aarhus, Denmark, studied the effect of meal-related dosing with repaglinide in patients with diabetes. The group compared 3-mealtime dosing with the same total daily dose when divided into 2 doses given with the morning and evening meals. Overall, 19 patients with type 2 diabetes, mean age 58 years, who were naive to antidiabetic drugs, were included. Twenty-four hour levels of blood glucose, plasma insulin, and plasma C-peptide were measured at baseline and 4 weeks after.

The researchers showed that repaglinide increased postprandial insulin levels and reduced postprandial glucose levels compared with baseline in both treatment groups. Fasting blood glucose and HbA1c levels were also significantly reduced by repaglinide. Repaglinide was more effective in improving glycemic control, including postprandial glucose and HbA1c levels, when given at each main meal compared with the same total daily dose given with the morning and evening meals. The authors suggest that, in addition to classic parameters of glycemic control, postprandial glucose may also be important because of the possible association between postprandial hyperglycemia and the risk for cardiovascular disease in diabetes. Diabetes Care 2002;25:342-6