Which drug is a meglitinide?

• A. Repaglinide
• B. Metformin
• C. Pioglitazone
• D. Acarbose

Answer: (A)

Meglitinides are insulin secretagogues that prompt the pancreas to release insulin by closing ATP-dependent potassium channels on beta cells, which depolarizes the cell and triggers calcium influx leading to insulin release. They are rapid-acting and short-lived, so they’re taken just before meals to boost the post-meal insulin response.

Repaglinide is a meglitinide, so it fits this mechanism and timing perfectly. The other drugs do not act as insulin secretagogues: metformin lowers hepatic glucose production, pioglitazone improves insulin sensitivity via PPAR gamma, and acarbose delays carbohydrate absorption in the gut.