Abstract

Elderly are more prone to develop hypoglycemia or miss meals. Repaglinide and nateglinide are suggested to have glucose-dependent insulinotropic effect. The aim of the present work was to test the effect of both drugs on serum glucose and insulin levels in fasting elderly diabetic patients. Eight elderly diabetics underwent a fixed dose single blinded, placebo controlled, six period, cross-over study at the Department of Geriatrics and Gerontology - University hospital. Patients received either repaglinide 2 mg, nateglinide 120 mg or a placebo, both under fasting and non-fasting states. Serum glucose and insulin were measured at 30 min intervals for four hours, following drug or placebo administration. None of the eight patients developed hypoglycemia under the fasting state in response to repaglinide and only one patient developed mild hypoglycemia (3.7 mmol/L) under the fasting state in response to nateglinide. Area under the serum  insulin concentration-time curve was significantly lower (p = 0.039) in the fasting state, compared to the non-fasting state, in response to repaglinide, but not to nateglinide. The present study suggests that in case of elderly diabetic patients, who may miss meals, repaglinide is a safe alternative to other antidiabetics. As for nateglinide, further studies are required.

Key words: Repaglinide, nateglinide, hypoglycemia, fasting, elderly.