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  • Prandialna regulacija glikemije : nov način zdravljenja sladkorne bolezni tipa 2 = Prandial glucose regulation : new approach to the treatment of type 2 diabetes
    Medvešček, Marko
    Background. The pancreatic beta-cell of a type 2 diabetic is incapable of responding to the elevated blood glu- coseconcentration, inparticular during the early phase of the mealrelated insulin ... release. This results in a failure to clear the glucose loads from successive meals, contributing significantly to the diabetic fasting hyperglycemia. An attempt restore metabolic control bystimulating insulin secretion at meal times in the prandial state offers a new approach to the antihyperglycemic treatment of type 2 diabetes. In the newtherapeutic concept, a rapid acting oral insulin secreting drug, administered before main meals, stimulating insulin release together with the meal itself, mimics the nondiabetic insulin response during the prandial state. Chronic stimulation of insulin secretion between meals as is typically the case during sulphonylurea therapy, is avoided. Tailoring treatment to mealtimes with shortacting insulin secreting drug, before each principal meal may improve the flexibility of meal times to individual lifestyle need. The first drug of the new prandial regulator generation is repaglinide. Its antihyperglycemic efficacy has been demonstrated in placebo-controlled studies, diminishing the glycated haemoglobin HbA 1c by 1. 7 to 2.1%. Comparedto sulphonylurea drugs, it was equally or rnore efficient, and safe due to less frequent and milder hypoglicemic episodes occuring only by day-time. 90 % of repaglinide is cleared via liver. Conclusions. The principleof prandial glucose regulation repesents a new approach to the type 2diabetes treatment. The first prandial regulator is repaglinide, characterised by good clinicall efficacy, and, first of all, safety. The dosing together with principal means short time of action, and its minimal clearence via kidneys all lead to much reduced risk of hypoglicemic epiosodes compared to salphonylurea treatment.
    Vir: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 68, št. 6, 1999, str. 379-382)
    Vrsta gradiva - članek, sestavni del
    Leto - 1999
    Jezik - slovenski
    COBISS.SI-ID - 10208473

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