Ranolazine, a drug for chest pain, improves blood sugar levels of people with type 2 diabetes

This study investigated whether ranolazine was an effective and safe treatment for people with type 2 diabetes.

Type 2 diabetes (T2D) is characterized by elevated blood glucose (sugar) levels. Treatment involves lowering blood glucose. Patients are advised to aim for an HbA1c (average blood glucose over the past 3 months) of less than 7.0%.

Patients can often have both T2D and heart problems at the same time. Thus it may be effective to treat such patients with drugs that target both conditions. Finding these treatments, though, can be complicated. Some drugs used to treat angina (chest pain occuring when the heart muscle is not receiving enough blood) can worsen T2D. Similarly, some antidiabetic drugs can increase the risk of heart problems. Ranolazine is a drug used for the treatment of angina. Studies have shown that ranolazine lowered blood glucose in patients with long-term angina. However, no studies to date have tested the effectiveness and safety of ranolazine in patients with T2D.

This study aimed to determine the effectiveness and safety of ranolazine in the treatment of patients with T2D. 465 patients with T2D who had poorly managed blood glucose by diet and exercise took part. The patients were treated for 24 weeks. Half of the patients were treated with ranolazine and half were treated with a placebo (a drug with no therapeutic effect, used as a control). The patients’ HbA1c was tested every 6 weeks. Patients were monitored for side effects for a further 2 weeks.

Ranolazine significantly reduced HbA1c by 0.76%. Patients being treated with a placebo had an average HbA1c reduction of 0.20%. Significantly more ranolazine patients (41.2%) achieved an HbA1c of less than 7.0% than placebo patients (25.6%).

More patients being treated with ranolazine (9.1%) suffered from side effects than patients in the placebo group (3.9%). However, the proportion of patients who discontinued the study due to side effects was similar in both groups (3.4% of placebo patients and 5.2% of ranolazine patients). The most common side effects experienced were constipation, headache, nausea and dizziness. 

This study concluded that ranolazine effectively lowered blood sugar levels of people with T2D. The authors suggest that ranolazine could be a suitable treatment for patients with long-term angina and T2D. 

Ranolazine is approved for the treatment of angina by the U.S. Food and Drug Administration. It has not been approved for the treatment of diabetes.

Consult your doctor if you or are interested in discussing ranolazine further or if you have T2D and heart problems and you are concerned about treatment complications.