meglitinid

Meglitinides are a class of oral antidiabetic drugs used to manage type 2 diabetes mellitus. They work by stimulating the pancreas to release more insulin. Unlike sulfonylureas, which have a longer duration of action, meglitinides are taken shortly before meals to help control postprandial (after-meal) blood glucose spikes. Their action is rapid and relatively short-lived.

The primary mechanism of action involves binding to specific receptors on the beta cells of the pancreas. This binding leads to the closure of ATP-sensitive potassium channels, causing depolarization of the cell membrane. This depolarization triggers the influx of calcium ions, which in turn stimulates the exocytosis of insulin-containing granules. The short duration of action is attributed to their rapid absorption and metabolism.

Common meglitinides include repaglinide and nateglinide. They are typically prescribed when diet and exercise alone are insufficient to control blood sugar, and are often used in combination with other antidiabetic medications such as metformin. Side effects are generally mild and can include hypoglycemia (low blood sugar), weight gain, and gastrointestinal upset. Hypoglycemia is a risk, particularly if meals are skipped or delayed after taking the medication. Patients are advised to eat within a certain timeframe after administration to minimize this risk. Meglitinides are not typically used in type 1 diabetes or diabetic ketoacidosis.