Synonyms in a broader sense
Diabetes drugs, 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. A prerequisite for this is that the pancreas itself can still produce insulin. When the blood sugar level has dropped due to the insulin released, the effect of the drugs diminishes.
The effect of the glinides is relatively short and lasts about 4 hours. Glinides can therefore be used very flexibly. They are always taken half an hour before meals. A hypoglycaemia is hardly possible due to the short-term intake before meals.
Dosage
At the beginning, under a 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, another tablet can be taken and the level lowered afterwards.
Repaglinide is very effective and can be used as the sole drug for lowering blood sugar levels. 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 with other oral antidiabetics.
Nateglinide is an excellent supplement if the maximum dose of metformin is already being taken and administration alone can no longer lower blood sugar levels sufficiently. Since glinides still belong to a relatively young class of oral antidiabetics, the studies are not yet conclusive enough in this respect. It is still uncertain whether long-term diabetes damage can really be prevented by the sole administration of repaglinide. It was only shown that the administration of glinides alone did not achieve good blood glucose control. In many cases, a combination with other drugs and insulin is therefore recommended.