Meglitinide

{{Short description|Chemical substance}} {{Infobox drug class | Name =  | Image = File:Meglitinide Structure.svg | ImageClass = skin-invert-image | Alt = | Caption = Meglitinide, the prototype of this drug class | Pronounce = | Synonyms =  | Use = Type 2 diabetes | ATC_prefix = A10BX | Mode_of_action = insulin secretagogue (release stimulator) | Mechanism_of_action = close potassium channels of beta cells | Biological_target = | Chemical_class =  | Drugs.com = {{Drugs.com|drug-class|meglitinides}} | Consumer_Reports = | medicinenet = | rxlist =  | MeshID = }} '''Meglitinides''' or '''glinides''' are a class of drugs used to treat type 2 diabetes.<ref name="pmid16735959">{{cite journal | vauthors = Blicklé JF | title = Meglitinide analogues: a review of clinical data focused on recent trials | journal = Diabetes & Metabolism | volume = 32 | issue = 2 | pages = 113–120 | date = April 2006 | pmid = 16735959 | doi = 10.1016/S1262-3636(07)70257-4 }}</ref>

== Drugs == Repaglinide (trade name Prandin)<ref name="repaglinide" /> gained US Food and Drug Administration approval in 1997.

Other drugs in this class include nateglinide (Starlix)<ref name="nateglinide" /> and mitiglinide (Glufast).

== Side effects == Side effects include weight gain and hypoglycemia. While the potential for hypoglycemia is less than for those on sulfonylureas,{{cn|date=March 2021}} it is still a serious potential side effect that can be life-threatening. Patients on this medication should know the signs and symptoms of hypoglycemia and appropriate management.

Repaglinide caused an increased incidence in male rats of benign adenomas (tumors) of the thyroid and liver.<ref name="repaglinide">[https://web.archive.org/web/20121017202932/http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020741s038lbl.pdf Prandin (repaglinide) prescribing information], fda.gov</ref> No such effect was seen with another drug of this class, nateglinide.<ref name="nateglinide">[https://web.archive.org/web/20110725155914/http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021204s011lbl.pdf Starlix (nateglinide) prescribing information], fda.gov</ref>

A 2020 Cochrane systematic review did not find enough evidence of reduction of all-cause mortality, serious adverse events, cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke or end-stage renal disease when comparing metformin monotherapy to meglitinide for the treatment of type 2 diabetes.<ref>{{cite journal | vauthors = Gnesin F, Thuesen AC, Kähler LK, Madsbad S, Hemmingsen B | title = Metformin monotherapy for adults with type 2 diabetes mellitus | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | issue = 6 | article-number = CD012906 | date = June 2020 | pmid = 32501595 | pmc = 7386876 | doi = 10.1002/14651858.CD012906.pub2 | editor-last = Cochrane Metabolic and Endocrine Disorders Group }}</ref>

== Mechanism of action == They bind to an ATP-dependent K+ (KATP) channel on the cell membrane of pancreatic beta cells in a similar manner to sulfonylureas but have a weaker binding affinity and faster dissociation from the SUR1 binding site. This increases the concentration of intracellular potassium, which causes the electric potential toward the intracellular side of the membrane to become more positive. This depolarization opens voltage-gated Ca2+ channels. The rise in intracellular calcium leads to increased fusion of insulin granula in the cell membrane, and therefore increased secretion of (pro) insulin.

== References == {{reflist}}

Category:Meglitinides Category:Methoxy compounds Category:Salicylamide ethers Category:Benzoic acids Category:Chloroarenes