How Do Antidiabetic Biguanides Meglitinides Work?

Antidiabetic biguanides/meglitinides are oral antidiabetic drugs used with a proper diet and exercise to control high blood sugar in people with type 2 diabetes mellitus (T2DM). T2DM is a long-term medical condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood. Controlling high blood sugar helps in preventing kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems and may also reduce the risk of a heart attack or stroke. This diabetes medication is a combination of two oral antihyperglycemic drugs (metformin and repaglinide) to control blood sugar in adults with T2DM who do not use daily insulin injections. 

Biguanides/meglitinides are not used to treat insulin-dependent or type 1 diabetes (a condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood) and diabetic ketoacidosis (increased ketones in the blood or urine).

Biguanides meglitinides are administered orally and are typically taken once or twice daily with or without food.

Biguanides meglitinides work in the following ways:

• Repaglinide:
  • It works by stimulating the beta cells of the pancreas to release more insulin into the bloodstream, allowing the body to better process glucose, and thereby lowering the blood sugar levels.
  • It particularly helps to lower blood sugar levels after meals.
• Metformin:
  • It belongs to a class “biguanide” that works by decreasing the amount of sugar produced by the liver and absorbed by the stomach/intestines from food.
  • It is an insulin sensitizer that inhibits hepatic glucose output and increases peripheral glucose uptake and utilization.

Biguanides/meglitinides are used as an adjunct to diet and exercise to improve glycemic control in adults with T2DM who are already treated with a meglitinide and metformin or who have inadequate glycemic control on a meglitinide alone or metformin alone.

Some of the common side effects include:

• Diarrhea
• Nausea
• Vomiting
• Stomach upset
• Muscle/joint pain
• Headache

Other rare side effects include:

• Lactic acidosis (increased lactic acid in the bloodstream which is produced when oxygen levels become low in cells within the areas of the body where metabolism occurs)
• Upper respiratory tract infection
• Weight gain
• Dizziness (feeling faint, weak, or unsteady)
• Hypoglycemia (low blood sugar level)
  • Sudden sweating
  • Fast heartbeat
  • Blurred vision
  • Tingling in hands/feet

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of antidiabetic biguanides/meglitinides include:

• Metformin/repaglinide
• PrandiMet