Starlix, containing nateglinide, works by stimulating the release of insulin from the pancreas. This happens only when blood glucose levels are elevated. It doesn’t increase insulin production when glucose levels are normal.
Specific Actions
- Nateglinide acts on ATP-sensitive potassium channels (KATP channels) in pancreatic beta-cells. Blocking these channels depolarizes the beta-cells, triggering calcium influx. This calcium influx, in turn, stimulates the release of pre-formed insulin granules from beta-cell secretory vesicles.
The effect is relatively rapid, offering improved postprandial (after-meal) glucose control. This is because it enhances insulin secretion specifically when needed – after food intake.
Important Considerations
Nateglinide’s action is short-lived; its effects typically last only for a couple of hours. This necessitates multiple daily doses, often timed with meals. It is primarily used as an adjunct therapy to diet and exercise, not as a standalone treatment. Hypoglycemia (low blood sugar) is a potential side effect, especially if combined with other glucose-lowering medications or if a meal is skipped after taking the drug.
Key Differences from Other Medications
Unlike sulfonylureas, nateglinide doesn’t bind to or permanently block KATP channels. This unique mechanism may contribute to a potentially lower risk of hypoglycemia when compared to some other glucose-lowering drugs.
