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A review of nateglinide in the management of patients with type 2 diabetes

Impaired insulin secretion occurs early in the pathogenesis of type 2 diabetes mellitus (T2DM) and is chronic and progressive, resulting initially in impaired glucose tolerance (IGT) and eventually in T2DM. As most patients with T2DM have both insulin resistance and insulin deficiency, therapy for T...

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Detalles Bibliográficos
Autores principales: Tentolouris, Nicholas, Voulgari, Christina, Katsilambros, Nicholas
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2350129/
https://www.ncbi.nlm.nih.gov/pubmed/18200800
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author Tentolouris, Nicholas
Voulgari, Christina
Katsilambros, Nicholas
author_facet Tentolouris, Nicholas
Voulgari, Christina
Katsilambros, Nicholas
author_sort Tentolouris, Nicholas
collection PubMed
description Impaired insulin secretion occurs early in the pathogenesis of type 2 diabetes mellitus (T2DM) and is chronic and progressive, resulting initially in impaired glucose tolerance (IGT) and eventually in T2DM. As most patients with T2DM have both insulin resistance and insulin deficiency, therapy for T2DM should aim to control not only fasting, but also postprandial plasma glucose levels. While oral glucose-lowering treatment with metformin and thiazolidinediones corrects fasting plasma glucose, these agents do not address the problem of mealtime glucose spikes that have been shown to trigger atherogenic processes. Nateglinide is a derivative of the amino acid D-phenylalanine, which acts directly on the pancreatic β-cells to stimulate insulin secretion. Nateglinide monotherapy controls significantly mealtime hyperglycemia and results in improved overall glycemic control in patients with T2DM by reducing glycosylated hemoglobin (Hb(A1c)) levels. The combination of nateglinide with insulin-sensitising agents, such as metformin and thiazolidinediones, targets both insulin deficiency and insulin resistance and results in reductions in Hb(A1c) that could not be achieved by monotherapy with other antidiabetic agents. In prediabetic subjects with IGT, nateglinide restores early insulin secretion and reduces postprandial hyperglycemia. Nateglinide has an excellent safety and tolerability profile and provides a lifetime flexibility that other antidiabetic agents could not accomplish. The aim of this review is to identify nateglinide as an effective “gate-keeper” in T2DM, since it restores early-phase insulin secretion and prevents mealtime glucose spikes throughout the day and to evaluate the results of ongoing research into its potential role in delaying the progression to overt diabetes and reducing its complications and mortality.
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spelling pubmed-23501292008-05-08 A review of nateglinide in the management of patients with type 2 diabetes Tentolouris, Nicholas Voulgari, Christina Katsilambros, Nicholas Vasc Health Risk Manag Review Impaired insulin secretion occurs early in the pathogenesis of type 2 diabetes mellitus (T2DM) and is chronic and progressive, resulting initially in impaired glucose tolerance (IGT) and eventually in T2DM. As most patients with T2DM have both insulin resistance and insulin deficiency, therapy for T2DM should aim to control not only fasting, but also postprandial plasma glucose levels. While oral glucose-lowering treatment with metformin and thiazolidinediones corrects fasting plasma glucose, these agents do not address the problem of mealtime glucose spikes that have been shown to trigger atherogenic processes. Nateglinide is a derivative of the amino acid D-phenylalanine, which acts directly on the pancreatic β-cells to stimulate insulin secretion. Nateglinide monotherapy controls significantly mealtime hyperglycemia and results in improved overall glycemic control in patients with T2DM by reducing glycosylated hemoglobin (Hb(A1c)) levels. The combination of nateglinide with insulin-sensitising agents, such as metformin and thiazolidinediones, targets both insulin deficiency and insulin resistance and results in reductions in Hb(A1c) that could not be achieved by monotherapy with other antidiabetic agents. In prediabetic subjects with IGT, nateglinide restores early insulin secretion and reduces postprandial hyperglycemia. Nateglinide has an excellent safety and tolerability profile and provides a lifetime flexibility that other antidiabetic agents could not accomplish. The aim of this review is to identify nateglinide as an effective “gate-keeper” in T2DM, since it restores early-phase insulin secretion and prevents mealtime glucose spikes throughout the day and to evaluate the results of ongoing research into its potential role in delaying the progression to overt diabetes and reducing its complications and mortality. Dove Medical Press 2007-12 /pmc/articles/PMC2350129/ /pubmed/18200800 Text en © 2007 Dove Medical Press Limited. All rights reserved
spellingShingle Review
Tentolouris, Nicholas
Voulgari, Christina
Katsilambros, Nicholas
A review of nateglinide in the management of patients with type 2 diabetes
title A review of nateglinide in the management of patients with type 2 diabetes
title_full A review of nateglinide in the management of patients with type 2 diabetes
title_fullStr A review of nateglinide in the management of patients with type 2 diabetes
title_full_unstemmed A review of nateglinide in the management of patients with type 2 diabetes
title_short A review of nateglinide in the management of patients with type 2 diabetes
title_sort review of nateglinide in the management of patients with type 2 diabetes
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2350129/
https://www.ncbi.nlm.nih.gov/pubmed/18200800
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