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Nateglinide Safe, Effective Therapy For Type 2 Diabetics With Mild To Moderate Hyperglycaemia

Nateglinide, a fast-acting insulin secretion agent that specifically targets postprandial hyperglycaemia, appears to be a safe and effective therapy for type 2 diabetics with mild to moderate fasting hyperglycaemia.

To assess the efficacy and safety of three fixed doses of nateglinide, Dr. Carola Saloranta at Helsinki University Hospital, in Finland, and colleagues conducted a multicentre, double-blind, randomized study of 675 patients with type 2 diabetes, who had moderately elevated fasting plasma glucose levels (7.0 to 8.3 mmol/l).

The patients were randomly assigned to receive placebo or 30 mg, 60 mg, or 120 mg of nateglinide for the 24-week study. In addition, the investigators conducted a sub-study of the effects on early insulin release and prandial glucose excursions following a standardized breakfast in 127 patients.

The researchers found that nateglinide was well tolerated by patients and that it elicited a dose-dependent reduction in both placebo-adjusted haemoglobin A(1c) (-0.26 to -0.39 percent) and fasting plasma glucose(-0.26 to -0.39 percent). There was also a dose-related increase in suspected hypoglycaemic episodes, the investigators noted.

However, confirmed hypoglycaemia occurred in only 5.3 percent of patients treated with the highest dose, compared with 1.2 percent among placebo-treated patients. Nateglinide significantly increased early insulin release and reduced prandial glucose excursions compared with placebo, the researchers reported.

"In sum, nateglinide is a safe and effective therapeutic option for treatment of patients with mild to moderate fasting hyperglycaemia," they concluded.
Clin Endocrinol Metab 2002; 87: 4171-4176 "Efficacy and safety of nateglinide in type 2 diabetic patients with modest fasting hyperglycemia."

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