Question:
Which one of the following oral hypoglycemic agents is NOT an insulin secretagogue?
Which one of the following oral hypoglycemic agents is NOT an insulin secretagogue?
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Three of these four drugs belong to the sulfonylurea or meglitinide class - one does not.
Updated On: Jul 16, 2026
- Gliclazide
- Glimepiride
- Repaglinide
- Rosiglitazone
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Verified By Collegedunia
The Correct Option is D
Solution and Explanation
Step 1: Understanding the Question:
The question tests the mechanism of action of common oral hypoglycemic drugs, and specifically asks which one does not work by stimulating insulin release from the pancreas.
Step 2: Key Concept or Approach:
Insulin secretagogues act on pancreatic beta cells: sulfonylureas and meglitinides bind the sulfonylurea receptor on the beta-cell ATP-sensitive potassium channel, close the channel, depolarise the cell, and trigger calcium-dependent insulin release. Thiazolidinediones (glitazones) work by a completely different mechanism - they activate PPAR-gamma receptors mainly in adipose tissue and improve peripheral insulin sensitivity, without directly making the pancreas secrete more insulin.
Step 3: Working Through the Options:
Gliclazide and glimepiride are both sulfonylureas, and repaglinide is a meglitinide - all three are classic insulin secretagogues that close beta-cell potassium channels. Rosiglitazone is a thiazolidinedione and is an insulin sensitizer, not a secretagogue.
Step 4: Conclusion:
The correct answer is Rosiglitazone, since it lowers blood glucose by improving insulin sensitivity rather than by stimulating insulin secretion.
The question tests the mechanism of action of common oral hypoglycemic drugs, and specifically asks which one does not work by stimulating insulin release from the pancreas.
Step 2: Key Concept or Approach:
Insulin secretagogues act on pancreatic beta cells: sulfonylureas and meglitinides bind the sulfonylurea receptor on the beta-cell ATP-sensitive potassium channel, close the channel, depolarise the cell, and trigger calcium-dependent insulin release. Thiazolidinediones (glitazones) work by a completely different mechanism - they activate PPAR-gamma receptors mainly in adipose tissue and improve peripheral insulin sensitivity, without directly making the pancreas secrete more insulin.
Step 3: Working Through the Options:
Gliclazide and glimepiride are both sulfonylureas, and repaglinide is a meglitinide - all three are classic insulin secretagogues that close beta-cell potassium channels. Rosiglitazone is a thiazolidinedione and is an insulin sensitizer, not a secretagogue.
Step 4: Conclusion:
The correct answer is Rosiglitazone, since it lowers blood glucose by improving insulin sensitivity rather than by stimulating insulin secretion.
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