Meglitinides are oral agents that can be used by patients with noninsulin dependent diabetes mellitus. It should be used appropriately if an optimum benefit is to be achieved.
Meglitinides include:
(1) repaglinide
(2) nateglinide
Mechanism of action: stimulation of insulin secretion from a functioning pancreas
Absolute contraindications:
(1) hypersensitivity to a meglitinide
(2) diabetic ketoacidosis
(3) no cellular sources of insulin:
(3a) Type 1 diabetes mellitus
(3b) absence of a functioning pancreas
Relative contraindications:
(1) pregnancy (safety not established)
(2) breastfeeding (safety not established)
(3) failure to respond to sulfonylureas
Precautions:
(1) The dose must be taken immediately before the meal. If the patient does not eat then the dose should not be taken. A dose should not be taken after a meal if not taken before.
(2) A meglitinide should not be used in combination with a sulfonylurea.
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