Repaglinide dose Titration in Patients with Type 2 Diabetes Mellitus: A Comparative Study between Diet Treated and Metformin Treated Patients
Keywords:
Repaglinide, metformin, dose titration, type 2 diabetes mellitusAbstract
Background and Objectives: Repaglinide is a nonsulfonylurea insulin secretagogue which has a fast onset and short duration of action that is used for prandial glucose regulation in type 2 diabetic patients, alone or in combination with other antidiabetic agents. The present study aimed to compare the effects of various doses of repaglinide in controlling blood glucose levels, especially postprandial blood glucose, as a monotherapy and in combination with metformin.
Methods: Patients with type 2 diabetes mellitus, which were poorly controlled with diet modification or metformin alone, were enrolled in this prospective study. The total number of the patients was 97, females (55) and males (42), at a mean age of 53 ± 8.1 years (range 31 − 69), 43 on Repaglinide monotherapy and 54 on repaglinide and metformin combination. Preprandial, postprandial blood glucose and glycated hemoglobin were recorded to determine repaglinide effect.
Results: the results showed that patients receiving repaglinide alone achieved glycemic control by 0.5 mg or 1 mg repaglinide before each main meal, while those receiving repaglinide in combination with metformin received higher doses (1mg, 2mg, and 4mg) of repaglinide before each main meal. Still, glycemic control was not achieved in some patients.
Conclusions: small doses of repaglinide (0.5−1.0 mg before main meals) was enough in type 2 diabetic patients with suboptimal control on diet alone to reach optimal glycemic control; but further dose titration up to (4 mg before main meals) is required in individuals who were previously on metformin with longer diabetes duration and advanced diabetic stages.
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