From the Guidelines
Diaprel (gliclazide) is primarily indicated for the treatment of type 2 diabetes mellitus in adults when diet, physical exercise, and weight loss alone are not sufficient to control blood glucose levels, particularly for patients who cannot take metformin or as an add-on therapy when metformin alone is inadequate, as recommended by the World Health Organization guidelines 1.
Key Points
- Diaprel belongs to the sulfonylurea class of medications and works by stimulating insulin secretion from functioning pancreatic beta cells, thereby reducing blood glucose levels.
- The standard dosage typically starts at 30-60mg once daily with breakfast for modified-release formulations, with possible titration up to a maximum of 120mg daily based on blood glucose response.
- Patients should be monitored for hypoglycemia, especially when starting treatment or adjusting doses, and Diaprel should be used cautiously in patients with renal or hepatic impairment.
- Diaprel is contraindicated in type 1 diabetes, diabetic ketoacidosis, severe renal or hepatic failure, and during pregnancy or breastfeeding.
Recommendations
- According to the World Health Organization guidelines, a sulfonylurea such as Diaprel can be given to patients with type 2 diabetes who do not achieve glycemic control with metformin alone or who have contraindications to metformin 1.
- The American Diabetes Association also recommends considering sulfonylureas as an option for second-line treatment in patients with type 2 diabetes who do not achieve glycemic control with metformin alone 1.
Important Considerations
- When using Diaprel, especially during fasting periods such as Ramadan, patients should be aware of the risk of hypoglycemia and take necessary precautions, such as adjusting the timing and dose of their medication 1.
- Healthcare providers should individualize treatment and consider the patient's disease characteristics, drug characteristics, and patient preferences when selecting a treatment regimen 1.
From the Research
Diaprel Indications
- Diaprel, also known as repaglinide, is indicated for the treatment of type 2 diabetes mellitus 2, 3, 4, 5, 6.
- It is used to improve glycemic control in adults with type 2 diabetes mellitus, in combination with diet and exercise 2, 3, 4, 5, 6.
- Repaglinide can be used as monotherapy or in combination with other oral antidiabetic agents, such as metformin, troglitazone, rosiglitazone, and pioglitazone 2, 3, 4, 5, 6.
- It is also used in combination with intermediate-acting insulin (NPH) given at bedtime 2.
Mechanism of Action
- Repaglinide stimulates insulin release from pancreatic beta-cells, reducing blood glucose levels 2, 3, 4, 5, 6.
- It has a rapid onset and relatively short duration of action, allowing for flexible meal schedules 2, 3, 4, 5, 6.
Clinical Efficacy
- Repaglinide has been shown to be effective in improving glycemic control in patients with type 2 diabetes mellitus, with reductions in HbA1c and fasting blood glucose levels 2, 3, 4, 5, 6.
- It has been compared to other oral antidiabetic agents, such as glibenclamide and glipizide, and has been shown to have similar or better efficacy 2, 3, 4, 5, 6.