A Review on the Impact of Nateglinide on Postprandial Glycemia, Insulin Secretion, and Cardiovascular Risk in Type 2 Diabetes

Nateglinide is a non-sulfonylurea insulin secretagogue used in managing type 2 diabetes mellitus (T2DM). It stimulates pancreatic beta cells to release insulin in response to meals which reduces postprandial blood glucose levels. Clinical studies from 2000 to 2024 have demonstrated that nateglinide effectively lowers blood glucose levels by improving glycemic control in T2DM patients when used in combination with other antidiabetic agents. It stimulates insulin release by closing ATP-sensitive potassium channels in pancreatic beta cells leading to the opening of calcium channels and subsequent insulin secretion. Nateglinide is characterized by a rapid onset and short duration of action in controlling postprandial glucose levels. When compared to other insulin secretagogues like sulfonylureas nateglinide has a lower risk of inducing hypoglycemia due to its shorter action duration. Additionally, nateglinide has shown favorable effects on insulin sensitivity and has been associated with minimal weight gain. It is often used in combination with other antidiabetic agents such as metformin to enhance glycemic control.