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may 98

The U.S. Food and Drug Administration has approved a new fast-acting oral agent to be marketed in the United States this spring: Novo Nordisk, called Prandin (repaglinide). It is the first of a new class of drugs to be taken without any other medication to control diabetes. It is fast-acting so it can be taken just before each meal. The drug peaks in 1 hour and is eliminated from the body in 3-4 hours mainly by the liver, whereas many other diabetes pills are eliminated through the kidneys. Because kidney disease can become a complication of diabetes after several years, Prandin may be an appropriate medication for people with kidney disease for whom some of the other oral agents are not an option. Prandin taken just before the meal works by stimulating beta cells, thus increasing the amount of insulin the beta cells release during and just after a meal. This produces smaller meal-related increases in blood glucose, which results in an overall decline in average blood glucose levels. Since the medicine is eliminated quickly from the bloodstream, it does not cause the beta cells to continue to release insulin for long periods of time. In tests, the incidence of hypoglycemia (low blood sugar) was negligible, according to the company, when patients missed a meal. The new drug is reported to be safe and effective, regardless of race and gender in both young and middle-age people with type 2 diabetes, as well as those older than 65, with some greater sensitivity to Prandin therapy reported in some elderly people. Prandin has not been studied in children and its safety has not been established in pregnant or nursing women. If you have type 2 diabetes and looking for better control, you might wish to discuss the use of Prandin with your physician. Since the drug's safety and effectiveness may be affected when taken with other medications, be sure to advise your physician of any other drugs (including over-the-counter medicines) that you take on a regular basis to avoid any possible drug interactions.