Repaglinide: a new short-acting insulinotropic agent for the treatment of type 2 diabetes.

Repaglinide, a carbamoylmethyl benzoic acid derivative, is rapidly absorbed, metabolized by the liver and eliminated primarily via the bile. It has a short duration of action and is taken immediately before each main meal. This regimen has been shown to provide superior glycaemic control compared with regular morning and evening dosing. A flexible preprandial only dosing regimen of repaglinide significantly lowers the risk of hypoglycaemia if a meal is missed or postponed. Combination therapy with metformin improves glycaemic control significantly compared with therapy with either drug alone in overweight patients. Repaglinide has an equivalent safety and efficacy profile to the sulphonylureas, although it is superior to glipizide in maintaining long-term glycaemic control The postprandial glucose levels are significantly lower with repaglinide compared with glibenclamide. In naive patients with Type 2 diabetes, repaglinide lowers fasting glucose concentrations and functions also as a prandial glucose regulator.