nateglinide and Arteriosclerosis

Diabetic macroangiopathy has already developed before diagnosis of diabetes mellitus. Postprandial hyperglycemia has been known as a risk factor for diabetic macroangiopathy and may be more powerful than fasting hyperglycemia. To intervene in hyperglycemia, insulin secretagogues, glinides which selectively stimulate early meal-induced insulin secretion and improve postprandial hyperglycemia, and sulfonylureas which enhance total daily insulin secretion and improve fasting hyperglycemia, have been prescribed as major oral antidiabetic agents. Few evidences that amelioration of glycemic control with insulin secretagogues lower the risk of cardiovascular diseases have been reported. But current studies have shown that intervention in postprandial hyperglycemia with drugs including glinides decreased thickness of carotid IMT as a surrogate marker of atherosclerosis. Results from on-going large scale intervention study with glinides may clarify whether amelioration of hyperglycemia lower the risk of atherosclerotic events.

Topics: Arteriosclerosis; Cardiovascular Diseases; Cyclohexanes; Diabetic Angiopathies; Glucose Intolerance; Hyperglycemia; Hypoglycemic Agents; Indoles; Insulin; Insulin Secretion; Isoindoles; Nateglinide; Phenylalanine; Postprandial Period; Risk Factors; Sulfonylurea Compounds

Topics: Arteriosclerosis; Blood Glucose; Cyclohexanes; Diabetic Angiopathies; Drug Therapy, Combination; Humans; Hypoglycemic Agents; Insulin; Insulin Resistance; Islets of Langerhans; Metformin; Nateglinide; Phenylalanine; Postprandial Period; Risk