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June 11, 2001

Pills for Diabetes

Question from Redwood City, California, USA:

I am a 57 year old who has had type 2 diabetes for six years and was on Prandin for about a year. My doctor switched me to Starlix because he said it would be more likely to prevent the hypoglycemia I occasionally get. Why would Starlix help prevent hypoglycemia?

Answer:

Prandin [repaglinide] and Starlix [nateglinide] are in the same class of drugs which increase the production of insulin when you eat. There appears to be subtle differences between the two even though they are of the same class.

The Starlix marketing materials suggest that it is less likely to cause a low blood sugar because of its short acting nature, and its more precise response to the rise in blood sugar. It should not make you produce insulin if you do not eat or you eat smaller meals than usual. hypoglycemia if the person using it adjusted the mealtime dose based on the carbohydrates they were eating. This doesn’t seem to be necessary with Starlix, from what the literature says. We’ve only been using it at our center for a few weeks so need to learn more from the people using it before we will know for sure if the marketing materials “tell it like it is”.

I would also suggest that you test your after eating blood sugar to see how your food and Starlix are matching. It might also be helpful to work with a diabetes educator to learn carbohydrate counting and how to interpret your blood sugar readings that you take at home.

KS