Meglitinides

(e.g. repaglinide, nateglinide)

• insulin secretagogues
• like sulfonylureas (but at different site) they bind to an ATP-dependent K+(KATP) channel on the cell membrane of pancreatic beta cells
• shot-acting, so useful for patients with an erratic lifestyle
• adverse effects include weight gain and hypoglycaemia (less so than sulfonylureas)