Combination Therapy for Patients with Type 2 Diabetes: Repaglinide in Combination with Metformin

Robert G Moses

Disclosures

Expert Rev Endocrinol Metab. 2010;5(3):331-342. 

In This Article

Repaglinide Plus Metformin Combination Therapy

Despite the availability of numerous treatment options, patients with T2DM still have unmet medical needs. Reduction in efficacy over time with existing therapies leads to hyperglycemia, which in turn can potentiate vascular complications. Newer combination therapies are thus sought after to achieve and maintain glycemic control. This review will focus on combination therapy of repaglinide and metformin. The rationale for this combination is based on the premise that both repaglinide and metformin target different pathophysiological components of T2DM (insulin secretion and insulin resistance, respectively) and different aspects of hyperglycemia (postprandial and fasting, respectively). In a recent study, Lund et al. have demonstrated that in nonobese T2DM patients, metformin reduced postprandial glycemia, triglycerides and free fatty acids similarly to repaglinide.[45] These data support a possible synergistic effect on postprandial hyperglycemia by combining metformin and repaglinide.

Currently, repaglinide/metformin combination therapy is indicated 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 monotherapy with meglitinide or metformin.[103] A single combination tablet offers increased patient convenience and the potential for increased adherence to therapy.

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