Repaglinide (Prandin in the U.S., GlucoNorm in Canada, NovoNorm elsewhere) belongs to a new chemical class of drugs called insulin secreting agents; it acts by causing a rapid and short-lived release of insulin by the body. The potential impact of matching insulin release to meal intake was tested along with the ability of this new drug to improve the control. of blood sugar levels Eighteen patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM) were divided into 2 groups. The group designated REP3 received repaglinide 3 time daily before meals, and REP2 received the same dosage given twice daily, both for a total of 4 weeks. The REP3 group was given 0.25 mg before breakfast, lunch and dinner, while the REP2 group was given 0.50 mg before breakfast, a placebo before lunch, and 0.25 mg before dinner. Doses were doubled after 2 weeks.
After 4 weeks, fasting blood glucose levels decreased significantly in both groups; 11.2 to 9.6 mmol/L in REP2, and 11.2 to 8.4 mmol/L in the REP3 group. The overall glycemic control was better in REP3 when compared to REP2, as blood glucose was 8.91 mmol/L in REP2 and 7.00 mmol/L in REP3. There was also a significant decrease in HbA1c levels in REP3 (7.5 to 6.5%) but a non-significant decrease in REP2 (7.1 to 6.8%). In both groups plasma insulin decreased to pre-treatment levels prior to the next meal and there was no increase in plasma insulin during the night time in comparison to pre-treatment levels.
Although these are just preliminary findings, they suggest that drugs of this class, can have a beneficial effect on blood sugar control in persons with diabetes.