Potential Advantage of Repaglinide Monotherapy in Glycemic Control in Patients with Type 2 Diabetes and Severe Renal Impairment

Abstract

Context. Oral anti-diabetic drugs (OADs) are leading option for treatment of type 2 diabetes (T2D). However, availability of OADs are limited in the presence of renal impairment (RI). Objective. In this study, we examined the efficacy of repaglinide, which is mainly metabolized and excreted via non-renal route, in patients with T2D and severe RI that consists mainly of chronic kidney disease (CKD) stage 4. Design, Subjects and Methods. This was an open label, single arm, interventional study by repaglinide monotherapy. The primary efficacy end point was HbA1c change from baseline to week 12. Results. Repaglinide treatment significantly reduced HbA1c levels from 7.7 ± 0.7% to 6.1 ± 0.3% (p<0.001) in 9 patients with severe RI (mean estimated glomerular filtration rate was 26.4 ± 7.5 mL/min/1.73m 2). Focusing on 4 patients who received DPP-4 inhibitor monotherapy at enrolment, switching to repaglinide also significantly improved HbA1c levels. No hypoglycemic symptoms or severe hypoglycemia was reported in patients who completed the period of 12 weeks. Conclusions. We demonstrated the efficacy of repaglinide in patients with T2D and severe RI. In case that DPP-4 inhibitors are not enough to achieve targeted range of glycemic control, repaglinide is another good candidate.

Overtreatment and Hypoglycemia Prevalence in Geriatric Patients with Type-2 Diabetes in the Turkish Population

“…Patients treated with sulphonylurea plus insulin, were shown to be at increased mortality risk when compared to metformininsulin combination (24). A new study showed that in addition to other well-known agents, repaglinide may also be a good candidate for achieving glycemic controls without causing hypoglycemia, especially in patients with renal impairment (25).…”

The In Vitro Cytotoxicity, Genotoxicity and Oxidative Damage Potential of the Oral Dipeptidyl Peptidase-4 Inhibitor, Linagliptin, on Cultured Human Mononuclear Blood Cells

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