Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Repaglinide is an oral medication for lowering blood sugar (glucose) in
individuals with diabetes. It is in a class of drugs for treating diabetes type 2 called meglitinides and is chemically unlike other anti-diabetic medication.
Approximately 90% of patients with diabetes have type 2 or non-insulin
dependent diabetes mellitus. (Type 2 diabetes usually occurs in adulthood,
and is associated with obesity and a strong family history of diabetes.)
Glucose intolerance in diabetes type II is caused by reduced insulin secretion from the pancreas after meals and resistance of the body's cells to insulin's effect which is to stimulate the cells to remove glucose from the blood. This leads to high levels of blood glucose.
Like Sulfonylureas, for example, glyburide (Diabeta; Glynase; Micronase), glipizide (Glucotrol), glimepiride
(Amaryl), tolbutamide (Orinase), and tolazamide (Tolinase), repaglinide stimulates cells in the pancreas to produce
insulin. Glyburide may be more potent than repaglinide at increasing
insulin release in persons with low or high blood glucose levels, whereas repaglinide
may be more potent in persons with moderate blood glucose levels. Repaglinide is
unusual in that it has a rapid onset of action and a short duration of action. When
taken just prior to meals, it promotes the release of insulin that normally occurs with meals and is responsible for preventing blood glucose levels from becoming high. It has been shown to lower
hemoglobin A1c levels by 1.6%
to 1.9%.
(Hemoglobin A1c is a blood test which measures the effectiveness of a drug in controlling
high blood glucose levels. The lower the hemoglobin A1c, the better the control.) Repaglinide was approved by the FDA
in 1997.
GENERIC AVAILABLE: no
PRESCRIPTION: yes
PREPARATIONS: Tablets: 0.5mg, 1mg, 2mg.
STORAGE: Tablets should be stored at room temperature,
15-30 C (59-86 F).
PRESCRIBED FOR: Repaglinide is used in treating type 2 diabetes, together with diet and exercise. It
can be used alone (monotherapy) or combined with metformin (Glucophage).
DOSING: Repaglinide is taken immediately before a meal or 15 to
30 minutes before a meal. It should be taken with every meal up to 4
times a day. Doses are adjusted by the physician to achieve the best
effect.
DRUG INTERACTIONS: Repaglinide is metabolized (eliminated) in the liver by an
enzyme called CYP3A4. Drugs that affect this enzyme may affect the blood levels of repaglinide and thus alter its glucose
lowering effect. The metabolism of repaglinide
may be prevented by ketoconazole (Nizoral), itraconazole (Sporanox),
fluconazole (Diflucan), erythromycin (Ery-Tab), and clarithromycin (Biaxin). As a result, blood levels of repaglinide rise and there is an enhanced glucose-lowering
effect. Dangerous hypoglycemic (very low blood glucose) reactions could occur. On the other
hand, the elimination of repaglinide may be increased with drugs that increase levels of CYP3A4 in the liver, such as barbiturates,
carbamazepine (Tegretol), and rifampin (Rifadin). This can result in lower blood levels of repaglinide and hyperglycemia (high blood glucose).
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Hypoglycemia is a syndrome caused by low blood sugar. Symptoms of hypoglycemia include palpitations, trembling, intense hunger, sweating, nervousness, and weakness. Consuming lifesavers, table sugar, soda, and juice are good treatment options for hypoglycemia.
Hyperglycemia is a serious health problem for diabetics. There are two types of hyperglycemia, 1) fasting, and 2)postprandial or after meal hyperglycemia. Hyperglycemia can also lead to ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome (HHNS). There are a variety of causes of hyperglycemia in people with diabetes. Symptoms include increased thirst, headaches, blurred vision, frequent urination and more. Treatment can be achieved through lifestyle changes or medications changes. Carefully monitoring blood glucose levels is key to prevention.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Managing your diabetes is important. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information is also provided in this article.
Taking care of a disease such as diabetes is a life-long process. Learn how to care for yourself or loved one with diabetes in situations such as illness, work, school, travel, or a natural disaster.
Diabetes mellitus is a condition in
which the body does not produce enough insulin or the
insulin that is produced is ineffective. Insulin is produced and secreted by the
pancreas and is needed for the proper storage and
utilization of nutrients (glucose, proteins, and fat) by the cells of the body.
Insulin allows nutrients to enter the cells of the body. For example, insulin
allows cells to remove glucose from the blood, and the glucose is used to
generate the energy that is necessary to fuel the activities of the cells. When
insulin is absent or ineffective and the cells receive inadequate amounts of
glucose, the body releases more glucose into the blood in an attempt to overcome
the block to glucose entering the cells. The additional glucose cannot penetrate
the cells, of course, and the glucose levels in the blood rise. High levels of
blood and urine glucose is what causes the symptoms and signs of diabetes. For more, please re...
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