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Starlix (Nateglinide)


Starlix is a fundamentally new drug referred to the class of early phase insulin secretion stimulants. According to its chemical structure, it is a unique amino acid, derivative of phenylalanine. A careful study of the pathogenesis of diabetes mellitus states that despite the loss of insulin secretion on glucose in the early phase of the disease its secretion in response to intravenous amino retains. This observation was the basis for creating a new group of drugs, the first of which is Starlix.

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Starlix pharmacological action

Taken before with a meal, there restoration of the early phase of insulin secretion takes place. The mechanism of this phenomenon is the rapid and reversible interaction of the drug with K + ATP-dependent channels of the beta cells of the pancreas. Unlike other oral hypoglycemic agents, Starlix causes pronounced insulin secretion within the first 15 minutes after ingestion, whereby fluctuations smoothed postprandial glucose concentration. The rapid advance in termination of action allows preventing the dangerous for the patient development of hyperinsulinemia and reactive hypoglycemia characteristic of long-acting drugs. The drug’s uniqueness also consists in the fact that the insulin secretion from the beta cells of the pancreas, induced by Starlix, depends on the concentration of glucose in the blood, i.e. the lowering of the concentration of glucose, insulin secretion decreases. Conversely, food intake and increased blood glucose concentration leads to a pronounced increase in insulin secretion. The noteworthy Starlix ability to significantly affect insulin secretion at low concentrations of glucose in the blood provides additional protection from hypoglycemia, for example, in case meals skipping.

Starlix indications for use

Studies have shown that the optimal drug Starlix monotherapy is prescribed for the patients with newly diagnosed type 2 diabetes. Starlix effect on postprandial hyperglycemia peaks is much more efficient than the sulfonylureas and biguanides. At the same time there is a significant dose-dependent decrease in glycated hemoglobin without changing blood lipids. Starlix effective as a monotherapy, or in combination (for example with metformin).

Thus, mentioned below are the following features and benefits of the drug Starlix:

• An effective tool for the treatment of type 2 diabetes in the form of mono-and combination therapy;

• Restores the early phase of insulin secretion;

• Reduces the "peaks" in blood sugar after a meal (postprandial hyperglycemia - a risk factor for fatal vascular events: myocardial infarction, stroke, chronic renal failure);

• Reduces the level of glycated hemoglobin; - Well tolerated (low risk of hypoglycemia, no weight gain).

Starlix administration

Typically, Starlix is prescribed at a dosage of 120mg 3 times a day before food ingestions (breakfast, lunch and dinner).

Starlix precautions

Importantly, Starlix doesn’t interact with drugs commonly used by diabetics (antihypertensives, anticoagulants, statins), and tolerability of the new drug in elderly patients (above 75 years old) is the same as in younger. Treatment was well tolerated Starlix: accompanied by an extremely low risk of hypoglycemia, does not cause weight gain, does not require dose adjustment in patients with renal impairment.

However, when applying Starlix to treat patients with diabetes type 2 the general precautions against hypoglycemia should be followed. The risk of hypoglycemia in patients on Starlix, like other antidiabetic drugs is higher in elderly patients. Reducing the concentration of glucose in the blood can be caused by alcohol, intense physical loads, and co-ingestion of other hypoglycemic agents.

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