Glinide
Synonyms in a broader sense
Diabetes medication, medication diabetes mellitus, repaglinide (e.g. Novonorm®) and nateglinide (e.g. Starlix®)
How do the glinides repaglinide (e.g. Novonorm®) and nateglinide (e.g. Starlix®) work
Repaglinide (Novonorm®) and nateglinide (Starlix®) promote the release of insulin from the pancreas. The prerequisite for this is that the pancreas itself can still produce insulin. If the blood sugar level has dropped due to the released insulin, the medication wears off.
The effect of the Glinide is relatively short and lasts about 4 hours. Glinide can therefore be used very flexibly. It is taken half an hour before meals. Hypoglycaemia is hardly possible due to the short-term intake before meals.
Note: Glinide
The rule is: "No food - no glinide tablets!"
dosage
At the beginning of therapy with repaglinide, 0.5 mg is given 3 times a day and the dose is increased to a maximum of 3 times 2 mg a day. For nateglinide, the dose is 120 mg 3 times a day.
If the blood sugar level should rise sharply after meals, a tablet can also be used here and the level can be lowered afterwards.
Repaglinide is very effective and can be used as the sole drug to lower blood sugar. A combination with metformin increases the blood sugar lowering effect and is sometimes useful in individual cases. In practice, nateglinide is combined with metformin because the blood sugar lowering effect is less than that of other oral antidiabetic drugs.
Nateglinide is an excellent addition when the maximum dose of metformin is already ingested and a single dose cannot lower blood sugar levels sufficiently.
Since glinides still belong to a relatively young substance class of oral anti-diabetic drugs, the studies are not conclusive enough in this regard. It is still uncertain whether long-term diabetes damage can really be prevented by administration of repaglinide alone. It only showed that administration of glinides alone did not achieve good blood sugar control. In many cases, a combination with other drugs and insulin is therefore recommended.
Side effects
As with other oral antidiabetic drugs, gastrointestinal problems such as nausea and vomiting as well as diarrhea or constipation can occur during therapy with repaglinide (Novonorm®) or nateglinide (Starlix®).
10 percent of those treated with glinides occurred a headache and diffuse visual disturbances attributed to fluctuating blood sugar levels.
During therapy with repaglinide (Novonorm®) or nateglinide (Starlix®), the Liver values be checked at least every six months, since the medication is the Liver function can affect.
Contraindications
Repaglinide (Novonorm®) or nateglinide (Starlix®) must not be taken if the liver values are poor and liver function is impaired. If the blood sugar level is high (above 300 mg / dl), therapy with repaglinide (Novonorm®) or nateglinide (Starlix®) is also not indicated. Other forms of therapy must be used here.
Drug interactions
Drugs that are used in high blood pressure are used (ACE inhibitors: Enalapril, Verapamil, Captopril, Ramipril, Lisinopril), increase the effect of glinides and can take a shortly after meals Hypoglycaemia favor. Your doctor will take this into account and work out a dose that is right for you. Also other antihypertensive agents from the group of Beta receptor blockers (Atenolol, Metoprolol, Bisoprolol) as well as some funds depressions (Moclobemide) can increase the effects of glinides and lead to hypoglycaemia. Some painkillers that are taken in high doses, for example in the context of a rheumatic disease (acetylsalicylic acid over 3 grams per day), can increase the effect of glinides.
Cortisone-containing drugs that are used in the context of chronic, rheumatic diseases as well as in asthma and chronic bronchitis (COPD) given can weaken the effect of glinides. The same applies to drugs that dilate the bronchial muscles (beta-mimetics: fenoterol, formoterol, Salbutamol, Salmeterol, terbutaline) and for diuretics that are prescribed for high blood pressure (hydrochlorothiazide, HCT, indapamide, xipamide). When starting therapy with repaglinide (Novonorm®) or nateglinide (Starlix®) it is imperative that you check your blood sugar regularly with these medications so that your doctor can react with a dose adjustment if necessary.
