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Title: Nateglinide improves early insulin secretion and controls postprandial glucose excursions in a prediabetic population
Authors: Saloranta, Carola
Guitard, Christiane
Pecher, Eckhard
De Pablos-Velasco, Pedro 
Lahti, Kaj
Brunel, Patrick
Groop, Leif
UNESCO Clasification: 32 Ciencias médicas
3205 Medicina interna
320502 Endocrinología
Keywords: Type-2 Diabetes-Mellitus
Postchallenge Hyperglycemia
Fasting Glucose
Life-Style, et al
Issue Date: 2002
Journal: Diabetes Care 
Abstract: OBJECTIVE - The purpose of this study was to evaluate the metabolic effectiveness, safety and tolerability of nateglinide in subjects with impaired glucose tolerance (IGT) and to identify a dose appropriate for use in a diabetes prevention study.RESEARCH DESIGN AND METHODS - This multicenter, double-blind, randomized, parallel-group, fixed-dose study of 8 weeks' duration was performed in a total of 288 subjects with IGT using a 2:2:2:1 randomization. Subjects received nateglinide (30, 60, and 120 mg) or placebo before each main meal. Metabolic effectiveness was assessed during a standardized meal challenge performed before and after the 8-week treatment. All adverse events (AEs) were recorded, and confirmed hypoglycemia was defined as symptoms accompanied by a self-monitoring of blood glucose measurement less than or equal to3.3 mmol/l (plasma glucose less than or equal to 3.7 mmol/l).RESULTS - Nateglinide elicited a dose-related increase of insulin and a decrease of glucose during standardized meal challenges, with the predominant effect on early insulin release, leading to a substantial reduction in peak plasma glucose levels. Nateglinide was well tolerated, and symptoms of hypoglycemia were the only treatment-emergent AEs. Confirmed hypoglycemia occurred in 28 subjects receiving nateglinide (30 mg, 0 [0%] 60 mg, 5 [6.6%] 120 mg, 23 [26.7%]) and in 1 (2.3%) subject receiving placebo.CONCLUSIONS - Nateglinide was safe and effective in reducing postprandial hyperglycemia in subjects with IGT. Preprandial doses of 30 or 60 mg nateglinide would be appropriate to use for longer-term studies to determine whether a rapid-onset, rapidly reversible, insulinotropic agent can delay or prevent the development of type 2 diabetes.
ISSN: 0149-5992
DOI: 10.2337/diacare.25.12.2141
Source: Diabetes Care[ISSN 0149-5992],v. 25, p. 2141-2146
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