Secretagogues vs. Oral Insulin
Secretagogues “borrow from Peter to pay Paul” a pharmaceutical “Ponzi scheme”
- While the newer agents have a built in glucose trigger they do not have the capability to ensure that the insulin released is released
- On time
- At the right dose (not enough or worse too much)
- Replacing first phase insulin at the expense of basal insulin in a patient who is already insulin deficient