The aim of this study was to compare glucose, insulin and proinsulin profiles during nateglinide and gliclazide treatment over an extended postprandial period.
Materials and methods
This double-blind crossover trial was conducted in 23 type 2 diabetic patients (mean HbA1C 6.6%; range 6.0—7.4%) who received, for one week each, nateglinide 120 mg t.i.d., gliclazide 80 mg b.i.d. and placebo, with a one week wash out period between treatments.
Results
The 2-hour postprandial glucose concentration was markedly lower with nateglinide than with gliclazide (5.83 vs. 7.21 mmol/L; p<0.05), as was the post-meal peak glucose elevation (8.63 vs. 9.72 mmol/L; p=0.085), which was associated with earlier, higher and shorter-lived insulin and proinsulin secretory responses. However, 0—7-hour AUCs during standardised meal test for glucose and insulin between the two drugs did not statistically differ. No symptomatic hypoglycaemic events occurred during the 7-hour test period.
Conclusion
Nateglinide was more effective than gliclazide in controlling postprandial hyperglycaemia and showed a faster effect on insulin and proinsulin secretion.
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