MEGLITINIDES | What Nurse Practitioners Need To Know

Today we are going to talk about the MEGLITINIDES and what nurse practitioners need to consider.  This drug class includes Repaglinide (Prandin) & Nateglinide (Starlix).  

OVERVIEW

 Now this is going to be easy for us to remember...the reason why is because this drug class is very similar to the SULFONYLUREAS. The only difference is that this drug class is very short acting but as far as the mechanism of action, it’s the same...stimulates the pancreas to release more insulin just like the SULFONYLUREAS.  Now in addition to this drug class being short-acting, it is more expensive than the SULFONYLUREAS & something else that we need to keep in mind is to educate our patients to take with a meal. This drug class is very effective. It drops the A1C anywhere between 0-5-1.5%. This is not typically a monotherapy agent but is going to be in combination with another agent.  Your ideal patient is a person that can still produce insulin, no dyslipidemia, not necessarily an overweight patient but has a slightly elevated fasting glucose and somebody who's hyperglycemia is just not being controlled by nutrition and exercise but needs a bit more help to reach the goal. 

SIDE EFFECTS

Similar to SULFONYLUREAS, hypoglycemia is your most common side effect. Now keep in mind, anytime you have a drug class that is stimulating the pancreas to release more insulin, there’s potential to drop the blood sugar.

PRECAUTIONS & CONTRAINDICATIONS

This drug class won’t be used with a type one or has someone with DKA. You will also need to monitor the renal and hepatic function to ensure that drug is clearing properly.  

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Below is the YouTube video that I made covering this class. You can subscribe to my channel HERE: https://www.youtube.com/c/KimETheDiabetesNP