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How does Starlix work?

Starlix comes from an amino acid called D-phenylalanine, and works by causing the beta cells in the pancreas to produce insulin. The sulfonylureas class of diabetes medications, including such drugs as Diabeta® and Micronase® (glyburide), Glucotrol®, and Amaryl®, also work by causing insulin production. However, there are two major difference between Starlix and the sulfonylureas. The first is that Starlix causes insulin to be produced much faster than the sulfonylureas do. This means that Starlix should be taken much closer to mealtimes than the sulfonylureas, because the body will begin producing insulin in a much shorter time period. The second difference is that the effects of Starlix do not last as long as the effects of the sulfonylureas. The effects of Starlix appear to wear off in less than one hour, compared to sulfonylureas which will continue to stimulate insulin production for several hours after being taken.

One advantage of a short duration of action is that there is less risk of hypoglycemia, or low blood glucose levels. Another advantage is that Starlix appears to be less likeley to cause the beta cells of the pancreas to "burn out."

When a person eats, the carbohydrates in the food are quickly converted by the body to glucose, resulting in a sharp increase in blood glucose levels. The "rapid on, rapid off," way in which Starlix works has been shown to help lower these sharp spikes in blood glucose which occur following a meal. The early studies that have been done seem to indicate that Starlix may provide better control of long-term blood glucose levels than some of the other diabetes medications, based upon measurements of patients' hemoglobin A1c. (See "An Overview of Hemoglobin A1c" for more information) The long-term decrease in blood glucose levels may help lower a diabetic patient's risk of developing problems with the eyes, kidneys, and heart.

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