Individualizing Therapy With Repaglinide: A Single-Centre Experience
https://doi.org/10.15605/jafes.041.S1
- Author:
Ioanna Ting Yung Sim
1
;
Florence Hui Sieng Tan
2
;
Pei Lin Chan
2
;
Ee Wen Loh
2
Author Information
1. Endocrine Unit, Sarawak General Hospital; Universiti Malaysia Sarawak (UNIMAS)
2. Endocrine Unit, Sarawak General Hospital
- Publication Type:Journal Article
- MeSH:
Repaglinide
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):55-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Repaglinide, a meglitinide analogue, has a rapid onset
and short duration of action. It offers prandial glucose
control while reducing hypoglycemia risk compared to
sulfonylureas. We describe its use in our special cohorts
of diabetic patients where repaglinide was prescribed to
reduce hypoglycemia in vulnerable patients or to optimize
glycemic control through pharmacotherapy intensification
or deintensification.
Cases:Cohort A comprised 12 elderly patients with multiple
comorbidities (mean age: 70.3 years; mean DM duration:
18.3 years) characterized by high glucose variability and
problematic hypoglycemia. In seven patients, low-dose
gliclazide was replaced with repaglinide with reduction
in hypoglycemic episodes. One patient on low-dose premixed insulin was successfully switched to preprandial
repaglinide. Two patients on basal insulin were able to
reduce their insulin requirements and stabilize their glucose
levels. A younger patient with autonomic dysfunction had
hypoglycemia while on insulin glulisine, while its omission
led to severe hyperglycemia. Substituting glulisine with
repaglinide resolved the glucose variability. Repaglinide
effectively reduced hypoglycemic episodes while maintaining glycemic stability, with a mean hemoglobin A1c
(HbA1c) reduction of 0.36% over 3–6 months.
Cohort B consisted of six younger patients (mean age: 35.3
years) with focus on optimizing HbA1c and improving
treatment adherence. Two patients on basal-bolus regimes
success-fully transitioned off bolus insulin to repaglinide,
significantly improving compliance. One patient on
basal insulin was successfully transitioned to an all-oral
regimen. Three patients on existing oral hypoglycemic
agents were started on repaglinide to close the glycemic
gap. Cohort B achieved a robust mean HbA1c reduction of
2.1% within 3–6 months.
Conclusion:Repaglinide remains an important armamentarium in
personalized diabetes management. Its pharmacokinetics
and flexible dosing allow intensification of glycemic
control while minimizing the risk of hypoglycemia. It also
offers a viable strategy for selected patients struggling
with complex insulin regime.
- Full text:2026073016291291839EP_A066.pdf
