Repaglinide is believed to work by which action?

• A. decreasing hepatic gluconeogenesis
• B. stimulating the release of insulin from the pancreas
• C. increasing hepatic gluconeogenesis
• D. reducing glucagon secretion from the pancreas

Answer: (B)

Repaglinide stimulates insulin release from the pancreas. It’s a meglitinide that closes ATP-sensitive potassium channels on pancreatic beta cells, leading to cell depolarization, calcium influx, and exocytosis of insulin. This makes insulin secretion rise in response to meals, helping to lower postprandial blood glucose with a rapid, short-lived action. It doesn’t primarily act by reducing hepatic glucose production or by increasing it, and it doesn’t mainly work by suppressing glucagon secretion; those effects belong to other drug classes. Because its effect depends on meal intake, it’s typically taken before meals to control glucose spikes after eating.