25.12 : 口服降血糖药：格列奈类

Glinides are insulin secretagogues that trigger insulin release from β cells by inhibiting K_ATP channels and controlling potassium efflux.

They share two binding sites with sulfonylureas and one unique binding site.

One drug, repaglinide, has a quick onset of action, with shorter effects lasting four to seven hours.

It controls postprandial glucose spikes effectively when taken before meals.

Repaglinide can be used in patients with renal impairment and the elderly. It can be a standalone treatment or combined with biguanides.

As it lacks sulfur, it can be used in type 2 diabetic patients with severe sulfur or sulfonylurea allergies.

Nateglinide, another agent, stimulates insulin secretion more rapidly but with less sustained action than other hypoglycemic agents.

These drugs show adverse effects, including hypoglycemic risk if meals are delayed, skipped, or low in carbohydrates.