How do the new insulin secretagogues compare

摘要: The availability of diabetes drugs with new properties in the last several years has prompted excitement about potential and unique advantages for care. That certainly been case insulin secretagogues, repaglinide nateglinide, which have earlier onset shorter duration action than sulfonylureas. niche that secretagogues occupy brings challenges to determining their therapeutic role. At present, they are expected be effective only a distinct window natural history disease process, stimulating secretion as it is process waning. One our enlarge define its limits more clearly we working toward near-normal glycemic control. So how, practice, do compare older, familiar agents act at very same sulfonylurea receptor? What criteria determine patient will benefit from one class or another? Do newer fact lead better control? fulfill promise while reducing hypoglycemia risk? Is there any reason think may offer benefits over another preserving β-cell function early course type 2 diabetes, leading prolongation tight control without requiring insulin? And question can’t avoid: Are worth extra cost compared agents? Several recent reviews provide excellent surveys literature on (1,2). But these questions not answered and, given costs other realities clinical research, some …