The University of Southampton
University of Southampton Institutional Repository

Meglitinide analogues for type 2 diabetes mellitus (Review)

Meglitinide analogues for type 2 diabetes mellitus (Review)
Meglitinide analogues for type 2 diabetes mellitus (Review)
BACKGROUND: In type 2 diabetes mellitus, impairment of insulin secretion is an important component of the disease. Meglitinide analogues are a class of oral hypoglycaemic agents that increase insulin secretion, in particular, during the early phase of insulin release.

OBJECTIVES: The aim of this review was to assess the effects of meglitinide analogues in patients with type 2 diabetes mellitus.

SEARCH STRATEGY: We searched several databases including The Cochrane Library, MEDLINE and EMBASE. We also contacted manufacturers and searched ongoing trials databases, and the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) websites.

SELECTION CRITERIA: We included randomised controlled, parallel or cross-over trials comparing at least 10 weeks of treatment with meglitinide analogues to placebo, head-to-head, metformin or in combination with insulin.

DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed trial quality.

MAIN RESULTS: Fifteen trials involving 3781 participants were included. No studies reported the effect of meglitinides on mortality or morbidity. In the eleven studies comparing meglitinides to placebo, both repaglinide and nateglinide resulted in a reductions in glycosylated haemoglobin (0.1% to 2.1% reduction in HbA1c for repaglinide; 0.2% to 0.6% for nateglinide). Only two trials compared repaglinide to nateglinide (342 participants), with greater reduction in glycosylated haemoglobin in those receiving repaglinide. Repaglinide (248 participants in three trials) had a similar degree of effect in reducing glycosylated haemoglobin as metformin. Nateglinide had a similar or slightly less marked effect on glycosylated haemoglobin than metformin (one study, 355 participants). Weight gain was generally greater in those treated with meglitinides compared with metformin (up to three kg in three months). Diarrhoea occurred less frequently and hypoglycaemia occurred more frequently but rarely severely enough as to require assistance.

AUTHORS' CONCLUSIONS: Meglitinides may offer an alternative oral hypoglycaemic agent of similar potency to metformin, and may be indicated where side effects of metformin are intolerable or where metformin is contraindicated. However, there is no evidence available to indicate what effect meglitinides will have on important long-term outcomes, particularly mortality.
1465-1858
CD004654-[52pp]
Black, Corri
2dd88049-95f0-484b-8aa0-878e8f52bf0e
Donnelly, Peter
7d211504-303d-40e6-ba40-56e53a6a1223
McIntyre, Linda
b322f804-ee5c-434e-a3b3-6a132dc2bdde
Royle, Pamela
cf97ad6f-555d-4735-8e67-93b4a997632c
Shepherd, Jonathan J.
dfbca97a-9307-4eee-bdf7-e27bcb02bc67
Thomas, Sian
23c09743-2933-4068-9012-b0f4b1c5842a
Black, Corri
2dd88049-95f0-484b-8aa0-878e8f52bf0e
Donnelly, Peter
7d211504-303d-40e6-ba40-56e53a6a1223
McIntyre, Linda
b322f804-ee5c-434e-a3b3-6a132dc2bdde
Royle, Pamela
cf97ad6f-555d-4735-8e67-93b4a997632c
Shepherd, Jonathan J.
dfbca97a-9307-4eee-bdf7-e27bcb02bc67
Thomas, Sian
23c09743-2933-4068-9012-b0f4b1c5842a

Black, Corri, Donnelly, Peter, McIntyre, Linda, Royle, Pamela, Shepherd, Jonathan J. and Thomas, Sian (2009) Meglitinide analogues for type 2 diabetes mellitus (Review). The Cochrane Library, 2007 (2), CD004654-[52pp]. (doi:10.1002/14651858.CD004654.pub2). (PMID:17975867)

Record type: Article

Abstract

BACKGROUND: In type 2 diabetes mellitus, impairment of insulin secretion is an important component of the disease. Meglitinide analogues are a class of oral hypoglycaemic agents that increase insulin secretion, in particular, during the early phase of insulin release.

OBJECTIVES: The aim of this review was to assess the effects of meglitinide analogues in patients with type 2 diabetes mellitus.

SEARCH STRATEGY: We searched several databases including The Cochrane Library, MEDLINE and EMBASE. We also contacted manufacturers and searched ongoing trials databases, and the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) websites.

SELECTION CRITERIA: We included randomised controlled, parallel or cross-over trials comparing at least 10 weeks of treatment with meglitinide analogues to placebo, head-to-head, metformin or in combination with insulin.

DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed trial quality.

MAIN RESULTS: Fifteen trials involving 3781 participants were included. No studies reported the effect of meglitinides on mortality or morbidity. In the eleven studies comparing meglitinides to placebo, both repaglinide and nateglinide resulted in a reductions in glycosylated haemoglobin (0.1% to 2.1% reduction in HbA1c for repaglinide; 0.2% to 0.6% for nateglinide). Only two trials compared repaglinide to nateglinide (342 participants), with greater reduction in glycosylated haemoglobin in those receiving repaglinide. Repaglinide (248 participants in three trials) had a similar degree of effect in reducing glycosylated haemoglobin as metformin. Nateglinide had a similar or slightly less marked effect on glycosylated haemoglobin than metformin (one study, 355 participants). Weight gain was generally greater in those treated with meglitinides compared with metformin (up to three kg in three months). Diarrhoea occurred less frequently and hypoglycaemia occurred more frequently but rarely severely enough as to require assistance.

AUTHORS' CONCLUSIONS: Meglitinides may offer an alternative oral hypoglycaemic agent of similar potency to metformin, and may be indicated where side effects of metformin are intolerable or where metformin is contraindicated. However, there is no evidence available to indicate what effect meglitinides will have on important long-term outcomes, particularly mortality.

Text
pdf - Version of Record
Download (8kB)

More information

Published date: 21 January 2009
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 345445
URI: https://eprints.soton.ac.uk/id/eprint/345445
ISSN: 1465-1858
PURE UUID: 4d337965-8051-424f-a6c6-0e358f98f95d
ORCID for Jonathan J. Shepherd: ORCID iD orcid.org/0000-0003-1682-4330

Catalogue record

Date deposited: 27 Nov 2012 13:24
Last modified: 19 Nov 2019 01:58

Export record

Altmetrics

Contributors

Author: Corri Black
Author: Peter Donnelly
Author: Linda McIntyre
Author: Pamela Royle
Author: Sian Thomas

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×