Mealtime tablets (i.e., prandial glucose regulators or glinides) are short-acting tablets taken before a carbohydrate-rich meal, which lower the blood sugar level after the meal.
Mealtime tablets (glinides) are used to manage type 2 diabetes in adults as a phase two or three medicine together with lifestyle management and metformin or other blood sugar-lowering medicine or basal insulin. They can also be used on their own, if metformin or other blood sugar-lowering medicines are not suitable. Meal-time tablets are known as glinides.
People with MODY (Mature Onset Diabetes in the Young) diabetes are another significant user group for which glinides combined with lifestyle management may be a sufficient treatment.
With new pharmaceutical products becoming available, the use of glinides to manage type 2 diabetes has become less common compared to previous years. The products used in Finland (7/2023), include repaglinide and, subject to a special permit, nateglinide.
Meal-time tablets directly stimulate the first phase secretion of insuling from the pancreatic beta cells.
Meal-time tablets are suitable for you, if your morning blood sugar is at a good level but increases drastically after a meal, indicating insufficient insulin secretion. The strongest effect occurs within 30-60 minutes and lasts for 3-4 hours.
Glinides are short-acting tablets, which are taken before the main meals. Depending on individual needs, they are taken 1–4 times a day before carbohydrate-rich meals. For some, one dose before the main meal may suffice in addition to other forms of treatment. If a meal does not contain carbohydrates, there is no need to take the medicine.
The therapy starts with a smaller initial dose of 0.5–1 mg, and the dose is increased once or twice a week, as required, in accordance with the amount of carbohydrates in the meal as well as the resulting increase in blood sugar level. A doctor gives advice regarding the suitable glinide dose on the basis of self-checking the blood sugar. The effect becomes quickly evident.
If you use glinides, you need to learn to calculate the amount of carbohydrates to a degree of approximately 10 g. Your nurse can help you with this. The glinide dose is measured to meet a specific quantity of carbohydrates. If a meal contains more carbohydrates than usual, you can increase the dose according to your doctor’s instructions. If the meal contains less carbohydrates than usual or if the meal is followed by exercise, you can reduce the dose, respectively.
Use of mealtime tablets has a risk for too low blood sugar levels. For this reason mealtime tablets are not suitable for persons of a very high age or who have trouble with eating regularly. A doctor assesses the suitability of mealtime tablets taking into account other medicines in use and possible liver or kidney failure. In the case of kidney failure, the dose is reduced.
All pharmaceutical products involve an individual risk of side effects.
Mealtime tablet may cause the blood sugar to drop too low, if the amount of carbohydrates in the meal is lower than the designated amount corresponding with the dose or if exercise is started right after the meal. Stomach ache or diarrhoea may also occur.
