Mitiglinide Calcium Tablets (Glufast) is a rapid-acting insulin secretagogue, primarily indicated for the treatment of type 2 diabetes. It works by stimulating pancreatic β-cells to promote insulin secretion, thereby controlling postprandial blood glucose. Despite its well-established efficacy, close attention must be paid to potential side effects during use, particularly certain severe adverse reactions.

Side Effects of Mitiglinide Calcium Tablets (Glufast)

Metabolic System-Related

Hypoglycemic symptoms: The most common side effect, with an incidence rate of 6.6%.

Manifestations include dizziness, hunger, tremors, fatigue, cold sweats, drowsiness, palpitations, etc. In severe cases, confusion or even coma may occur.

Gastrointestinal Reactions

These include nausea, vomiting, stomach discomfort, abdominal pain, diarrhea, constipation, loss of appetite, or increased appetite, with an incidence rate ranging from 0.1% to 5%.

Skin Reactions

Rash, eczema, dry skin, pruritus (itching), etc., may occur, most of which are mild in severity.

Reactions in Other Systems

Neuropsychiatric system: Headache, dizziness, numbness, insomnia, etc.

Musculoskeletal system: Back pain, myalgia (muscle pain), arthralgia (joint pain).

Abnormal liver function indicators: Elevations in AST (aspartate transaminase), ALT (alanine transaminase), and γ-GTP (gamma-glutamyl transpeptidase).

Circulatory system: Palpitations, increased blood pressure, ventricular extrasystoles (premature ventricular contractions), etc.

Severe Side Effects of Mitiglinide Calcium Tablets (Glufast)

Myocardial Infarction

The incidence rate is approximately 0.1%, and it is more common in patients with pre-existing ischemic heart disease.

Regular cardiovascular assessments should be conducted during medication use.

Severe Hypoglycemia

If hypoglycemia is not treated promptly, it may lead to loss of consciousness, convulsions, or even coma.

The risk is increased, especially when used in combination with insulin or other hypoglycemic drugs.

Hepatic Dysfunction

Although the frequency is unknown, significant elevations in AST, ALT, and γ-GTP may occur, indicating drug-induced liver injury.

Regular monitoring of liver function is recommended.

Precautions for Mitiglinide Calcium Tablets (Glufast)

Contraindications

Patients with severe ketosis, diabetic coma, or type 1 diabetes.

Patients with severe infections, those undergoing pre- or post-operative care, or those with severe trauma.

Patients allergic to any component of this product.

Pregnant women or women who may become pregnant.

Dosage and Administration Instructions

Timing of administration: Must be taken within 5 minutes before each meal; administration after meals will reduce the drug’s efficacy.

Initial dosage: For adults, the usual initial dosage is 10 mg per dose, three times a day. For elderly patients or those with hepatic/renal impairment, a starting dosage of 5 mg per dose is recommended.

Individualized adjustment: Adjust the dosage in a timely manner based on blood glucose monitoring results.

Medication Use in Special Populations

Elderly patients: Physiological function declines, increasing the risk of hypoglycemia. Treatment should start with a low dosage, and blood glucose should be closely monitored.

Patients with hepatic/renal impairment: Drug metabolism and excretion are slowed, increasing the risk of hypoglycemia; cautious use is required.

Lactating women: Discontinuation of the drug or breastfeeding should be considered, as the drug may be excreted in breast milk.

Patient Education and Self-Monitoring

Patients should understand the symptoms of hypoglycemia and corresponding management measures, and carry sugary foods with them at all times.

Regularly monitor indicators such as blood glucose, liver function, and renal function—especially during the initial treatment phase and dosage adjustment phase.

If blood glucose control remains unsatisfactory after 2–3 months of continuous medication, consideration should be given to adjusting the treatment regimen.