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Secretagogues
Sulfonylureas have been the mainstays of oral hypoglycemic therapy for the past 40 years. Sulfonylureas help to increase the secretion of insulin but have no effect on insulin sensitivity. The main side effects of this class of agents is hypoglycemia and weight gain. Primary failure of this drug is due to insulin insufficiency. Secondary failure may include poor dosing, lack of physical activity and obesity. (19,25,28,30,48)
The newer class of secretagogues includes Prandin and Starlix. These medications also stimulate pancreatic insulin release, but in contrast to the sulfonylureas, they start acting within 30 minutes and are cleared by the body within 3 to 4 hours. These drugs should be taken immediately prior to each meal. The main advantage of these medications is that there is more flexibility in timing of meals, less weight gain and hypoglycemia. (48)
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Intervention
