Nateglinide Improves Beta-Cell Function in Diabetics

Using a mathematical modeling approach, Italian and US researchers have shown that the oral insulin secretagogue nateglinide improves beta-cell function in mild type 2 diabetic patients. Lead investigator Dr. Andrea Mari stated that, “One problem clinicians have in testing drugs that enhance insulin secretion in diabetics is that "these drugs lower glucose concentration, and insulin secretion, which is controlled by the glucose levels, does not increase." "This puzzle is solved," she continued, "by means of a mathematical model of the insulin-producing cells…with which is it possible to assess the functionality of the beta cells — not just the insulin response."

In their study, Dr. Mari of the Institute of Biomedical Engineering, used this approach to analyze data from 108 type 2 diabetics who were randomized to 30 mg, 60 mg or 120 mg of nateglinide or placebo.

The subjects were given a test meal at baseline and at the end of the 24-week study. There was no difference in fasting or in total insulin secretion during the meal. However, rate sensitivity, a parameter associated with beta cell insulin release, increased at the lowest drug dose. Higher doses had no further effect. Glucose sensitivity also increased, as did indicators of insulin secretion.
"Using this methodology," Dr. Mari concluded, "it is clearly shown that beta-cell function is improved by nateglinide, in spite of the fact that insulin levels are not significantly increased."
Diabetes Care 2005;28:1132-1138.