Question

All are true about meglitinides except?

• A. Decreases postprandial hyperglycemia
• B. Incidence of hypoglycemia is less common than sulfonylureas
• C. It decreases insulin resistance
• D. Causes stimulation of insulin release from pancreas

Hint:

Are meglitinides insulin secretagogues or insulin sensitizers?

Answer 1

The Correct Option is C

Step 1: Recall the mechanism of meglitinides (repaglinide, nateglinide). They are insulin secretagogues that close the ATP-sensitive potassium channels on pancreatic beta cells, triggering insulin release. So option D is true.
Step 2: Because of their rapid onset and short duration of action, meglitinides are taken with meals to specifically blunt the post-meal glucose spike, so option A (decreases postprandial hyperglycemia) is true.
Step 3: Their short half-life means insulin is released only around mealtimes, so the risk of hypoglycemia between meals is lower than with longer-acting sulfonylureas, making option B true.
Step 4: Meglitinides work by increasing insulin secretion; they do NOT improve insulin sensitivity. Reducing insulin resistance is the action of insulin sensitizers such as metformin (biguanides) and pioglitazone (thiazolidinediones). Therefore option C is FALSE.
Step 5: The exception is option C, so it is the correct answer.