If the backdrop of the drug is better postprandialnoy fast, but fast bladders remains elevated, it can be successfully combined with metforminom or prolonged insulin at night. Nateglinid is another representative prandialnyh regulators fast. It is a derivative Dfenilalanina amino acids. Mode of Action and all major farmakodinamicheskie and pharmacokinetic properties similar to repaglinidom. It may be noted that nateglinid practically does not require the selection of doses. The standard single dose of 120 mg every major receiving food. Tiazolidindiony Preparaty tiazolidindionovogo stimulants (pioglitazon, roziglitazon) entered into clinical practice in recent years. Like biguanidam, these drugs do not stimulate insulin secretion, but increases the sensitivity to the peripheral tissues. The compounds of this class act as agonists of nuclear receptors PPAR-g (peroxisome proliferatoractivated receptor). PPAR-g receptors are found in the fat, muscle and liver tissue. Enabling PPAR-g receptors modulating the transcription of several genes related to the effects of insulin and the cells involved in controlling the level of glucose and lipid metabolism. In addition to reducing fast, improving the sensitivity of tissues to insulinu favorable effect on the lipid profile (increased levels of high-density lipoprotein, decreasing triglycerides). Given that these drugs act by stimulating transcription of genes, for maximum effect required to 2-3 months. In clinical studies of these drugs to provide the reduction of HbA1c in monotherapies around 0,5-2%. Preparations for the class can be used in conjunction with SAP, insulin or metforminom. Combining with metforminom justified by the fact that the biguanidov aimed more at suppressing glyukoneogeneza, and the tiazolidindionov at increasing peripheral glucose utilization.
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