Oral Diabetes Medications

D-phenylalanine Derivatives

Nateglinide (Starlix) is the only D-phenylalanine derivative approved by the FDA. Like sulfonylureas and Prandin, it stimulates secretion of insulin from the pancreas. Starlix is taken before eating.

It is most effective in people who have very high postmeal blood glucose levels (more than 200 mg/dL). It can be taken by itself or in combination with metformin.

Because Starlix stimulates rapid release of insulin, its most common side effect is hypoglycemia.

The drug should be used with caution in people with serious liver disease. In rare cases, it may cause upper respiratory infection, flu symptoms, dizziness, and joint pain.

Publication Review By: Written by: Christopher D. Saudek, M.D.; Simeon Margolis, M.D., Ph.D.

Published: 21 Apr 2009

Last Modified: 10 Mar 2015