Repaglinide: a challenge to the sulphonylureas

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IN BRIEFRepaglinide is a new oral antihyperglycaemic drug that may be particularly useful for patients with type 2 (non-insulin-dependent) diabetes mellitus who require control of postprandial glucose levels.The drug is short acting with a rapid onset of effect, and acts by increasing insulin secretion. Repaglidine should always be taken shortly before a meal, and should not be taken if a meal is missed. The long-term glycaemic control provided by repaglinide is similar to that achieved with glibenclamide (glyburide).Repaglinide appears to be generally well tolerated, with a tolerability profile that resembles that of the second-generation sulphonylureas. Hypoglycaemia and bodyweight gain are among the most significant adverse effects that occur with repaglinide. Because the drug is excreted by the biliary and faecal routes, repaglinide is a suitable agent for treating patients with diabetes mellitus and renal impairment.

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