Nateglinide
Sources réglementaires consultées
Indications approuvées
- Traitement complémentaire au régime alimentaire et à l'exercice pour améliorer le contrôle glycémique chez l'adulte atteint de diabète de type 2.
Contre-indications
Absolues
- Hypersensibilité au natéglinide ou à l'un des excipients.
- Diabète de type 1 avec peptide C négatif.
- Acidocétose diabétique, avec ou sans coma.
- Grossesse et allaitement.
- Insuffisance hépatique sévère.
Mises en garde cliniques
- Mise en garde majeure · Peut provoquer une hypoglycémie et des réactions d'hypersensibilité. — CIMA STARLIX, registro 01174012
- Mise en garde majeure · Une insuffisance rénale sévère sans hémodialyse augmente la sensibilité à l'hypoglycémie ; envisager l'arrêt si l'effet hypoglycémiant est majoré. — https://cima.aemps.es/cima/dochtml/ft/01174012/FT_01174012.html
Interactions médicamenteuses
- ModéréeMédicaments qui augmentent l'effet hypoglycémiant
Mécanisme: Les IEC, les AINS, les salicylés, les IMAO, les bêtabloquants non sélectifs, les hormones anabolisantes et les inhibiteurs puissants du CYP2C9 peuvent augmenter ou prolonger l'effet hypoglycémiant.
Recommandation: Surveiller étroitement la glycémie lors de l'instauration ou de l'arrêt de ces médicaments et ajuster le natéglinide si nécessaire.
https://cima.aemps.es/cima/dochtml/ft/01174012/FT_01174012.htmlCIMA registro 01174012
- ModéréeMédicaments qui réduisent l'effet hypoglycémiant
Mécanisme: Les diurétiques, les corticostéroïdes, les agonistes bêta-2, la somatropine, les analogues de la somatostatine, la rifampicine, la phénytoïne et le millepertuis peuvent réduire l'effet hypoglycémiant.
Recommandation: Surveiller étroitement la glycémie lors de l'instauration ou de l'arrêt de ces médicaments et ajuster le natéglinide si nécessaire.
https://cima.aemps.es/cima/dochtml/ft/01174012/FT_01174012.htmlCIMA registro 01174012
Effets indésirables
Communs (≥1%)
Hypoglycémie · Douleur abdominale · Diarrhée · Dyspepsie · Nausées
Rares mais graves
Hypoglycémie sévère · Réaction d'hypersensibilité · Élévation des enzymes hépatiques · Érythème polymorphe
Grossesse et allaitement
Le natéglinide est contre-indiqué pendant la grossesse et l'allaitement.
Bibliographie récente (PubMed)
Available data on the effects of anti-diabetic drugs on fracture risk are contradictory. Therefore, our study aimed to analyze all available data on the effects of anti-diabetic drugs on fracture risk in type 2 diabetes mellitus (T2DM) patients. Embase, Medline, ClinicalTrials.gov, and Cochrane CENTRAL were searched for relevant trials. All data analyses were performed with STATA (12.0) and R language (3.6.0). Risk ratio (RR) with its 95% confidence interval (CI) was calculated by combining data for the fracture effects of anti-diabetic drugs, including sodium-glucose co-transporter 2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, meglitinides, α-glucosidase inhibitors, thiazolidinediones, biguanides, insulin, and sulfonylureas. One hundred seventeen eligible randomized controlled trials (RCTs) with 221,364 participants were included in this study. Compared with placebo, trelagliptin (RR 3.51; 1.58-13.70) increased the risk of fracture, whereas albiglutide (RR 0.29; 0.04-0.93) and voglibose (RR 0.03; 0-0.11) decreased the risk of fracture. Other medications were comparable in terms of their effects on fracture risk, and no statistical significance was observed. In terms of fractures, voglibose (0.01%) may be the safest option, and trelagliptin (13.64%) may be the worst. Sensitivity analysis results were consistent with those of the main analysis. No statistically significant differences were observed in the regression coefficients of age (1.03; 0.32-2.1), follow-up duration (0.79; 0.27-1.64), and sex distribution (0.63; 0.15-1.56). We found varied results on the association between the use of anti-diabetic drugs and fracture risk. Specifically, trelagliptin raised the risk of fracture, whereas voglibose and albiglutide showed benefit with statistical difference. Other drugs were comparable in terms of their effects on fracture risk. Some drugs (omarigliptin, sitagliptin, vildagliptin, saxagliptin, em
The progression of carotid intima-media thickness (cIMT) can partially predict the occurrence of future cardiovascular events. This network meta-analysis compared the effects of 14 antidiabetic drugs (acarbose, alogliptin, exenatide, glibenclamide, glimepiride, ipragliflozin, metformin, nateglinide, pioglitazone, rosiglitazone, sitagliptin, tofoglifozin, troglitazone, voglibose) on the progression of cIMT. PubMed, EMBASE, Cochrane Library, and Web of Science were searched to screen all clinical trials of treatment of cIMT with hypoglycemic agents before March 1, 2024. The differences in the changes in cIMT between the treatment group and control group were evaluated. After screening 8395 citations, 25 studies (6675 patients) were included. The results indicated that exenatide had the best efficacy in slowing down cIMT progress, and exenatide [MD=-0.13,95%CI (-0.25, -0.01)], alogliptin [MD=-0.08,95%CI (-0.13, -0.02)] and metformin [MD=-0.05, 95%CI (-0.09, -0.02)] are more effective than placebo. Long-term treatment of exenatide, alogliptin, and metformin may be more effective than other hypoglycemic drugs in slowing the progression of cIMT. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024519474.
Nateglinide belongs to the meglitinide class of insulin secretagogues. It is used as an oral hypoglycemic agent for the treatment of type 2 diabetes mellitus. Nateglinide is an amino acid derivative of D-phenylalanine that binds to the ATP-sensitive potassium channels in pancreatic beta cells and stimulates the secretion of insulin. In this chapter, various aspects of Nateglinide are discussed. This includes methods used for its synthesis, physicochemical properties, and different techniques employed to determine its structure, such as elemental analysis, IR, UV, (1H and 13C) NMR, MS, and XRD. Additionally, the chapter covers a literature review of various methods of analysis of Nateglinide, such as X-ray powder diffraction pattern analysis, differential scanning calorimetry, spectrophotometric, chromatographic, capillary electrophoresis and immunoassay methods. Moreover, the pharmacology of the title drug including pharmacokinetics, pharmacodynamics, mechanism of action, drug-drug and drug-food interactions are also reviewed.
To elucidate the long-term cardiovascular benefit of lowering postprandial hyperglycemia (PPG) in early-stage T2DM patients. This 10-year post-trial follow-up study included 243 patients from the DIANA (DIAbetes and diffuse coronary Narrowing) study, a multi-center randomized controlled trial which compared the efficacy of one-year life-style and pharmacological (voglibose/nateglinide) intervention lowering PPG on coronary atherosclerosis in 302 early-stage T2DM subjects [impaired glucose tolerance (IGT) or newly-diagnosed T2DM] (UMIN-CTRID#0000107). MACE (all-cause death, non-fatal MI or unplanned coronary revascularization) were compared in (1) three assigned therapies (life-style intervention/vogliose/nateglinide) and (2) patients with and without improvement of PPG (reversion from IGT to NGT or from DM to IGT/NGT on 75 g oral glucose tolerance test). During the 10-year post-trial observational period, voglibose (HR = 1.07, 95%CI: 0.69-1.66, p = 0.74) or nateglinide (HR = 0.99, 95%CI: 0.64-1.55, p = 0.99) did not reduce MACE. Similarly, achieving the improvement of PPG was not associated with a reduction of MACE (HR = 0.78, 95%CI: 0.51-1.18, p = 0.25). However, in IGT subjects (n = 143), this glycemic management significantly reduced the occurrence of MACE (HR = 0.44, 95%CI: 0.23-0.86, p = 0.01), especially unplanned coronary revascularization (HR = 0.46, 95%CI: 0.22-0.94, p = 0.03). The early improvement of PPG significantly reduced MACE and unplanned coronary revascularization in IGT subjects during the post-trial 10-year period.