Abstract

ABSTRACT:
BACKGROUND:
Nateglinide, structural derivative of the amino acid D-phenylalanine, is a stimulator that controls the meal time spikes to restore of the early phase of insulin secretion lost in type II diabetes.
OBJECTIVE:
To evaluate the efficacy and tolerability of nateglinide in combination with metformin in a sample of Iraqi type II diabetic individuals,and to look for its side effects.
Setting: The Specialized Center of Endocrinology and Diabetes-Baghdad.
Design: During the period between September 2001 and January 2002 a sample of ten type II diabetic patients whose glycemic control is poor on metformin glibenclamide combination. Glibenclamide was replaced by nateglinide. Postprandial plasma glucose levels were checked frequently, and glycosylated hemoglobin (HBa1c) was evaluated in the 24th and 32nd week of the study period.
RESULTS:
It has been found that using nateglinide in a dose of 120 mg before each main meal three times daily does not reduce plasma glucose HBa1c to the desired levels, but using it in a dose of 180 mg before each meal results in gradual satisfactory decrement in plasma glucose and HBa1c. No adverse effects were recorded and metformin - nateglinide combination was well tolerated.
CONCLUSION:
Nateglinide and metformin improve overall glycemic control. Nateglinide decreases meal time glucose excursions. Their combination has a complementary effect, improving HBa1c and postprandial hyperglycemia. No adverse effects were recorded and metformin - nateglinide combination was well tolerated.