title: Mitiglinide for type 2 diabetes treatment.
abstract: BACKGROUND
  Mitiglinide , a rapid-acting insulin secretion-stimulating agent, is approved in Japan for the treatment of type 2 diabetes (T2DM). Rapid-acting insulin secretion-stimulating agents, also known as meglitinides, are not recommended as monotherapy, however, may be added to metformin therapy for those patients with continued postprandial hyperglycemia. Currently, repaglinide (Prandin®) and nateglinide (Starlix®) are the only US Food and Drug Administration-approved agents in this class of drugs.
  
  
  METHODS
  This review describes the pharmacology, pharmacokinetics, efficacy, safety, and potential role in therapy of mitiglinide therapy. Phase II and III clinical studies have demonstrated that A1C levels should be expected to decrease by 0.17 - 1.1% with mitiglinide therapy. The most common adverse effects in these studies were hypoglycemia related.
  
  
  CONCLUSIONS
  Meglitinides are limited by their cost, frequency of administration, and minimal available data assessing clinical impact; however, mitiglinide shows selective action on the pancreatic β-cells, has greater affinity for β-cells, and limited metabolism when compared to other meglitinides. These properties may allow more utility in patients with chronic kidney disease or at high risk of hypoglycemia. The primary role in therapy for mitiglinide is the treatment of elevated postprandial glucose in patients with T2DM.
authors.affiliation: Associate Clinical Professor of Pharmacy Practice, Auburn University Harrison School of Pharmacy , 301 Governors Drive, Huntsville, AL 35801 , USA.
authors.forename: Haley M
authors.initials: HM
authors.lastname: Phillippe
authors.forename: Kurt A
authors.initials: KA
authors.lastname: Wargo
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D054833:Isoindoles / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D054833:Isoindoles; C087255:mitiglinide