Post-prandial glycaemic reduction by an alpha-glucosidase inhibitor in type 2 diabetic patients with therapeutically attained basal normoglycaemia

Diabetes Res. 1991 Dec;18(4):149-53.

Abstract

Post-prandial glucose excursions remain elevated in most patients with diabetes even when normal fasting plasma glucose levels have been achieved. In 39 patients with type 2 diabetes who had attained basal normoglycaemia by therapy with diet alone, a sulphonylurea, a basal insulin supplement or basal plus prandial insulin the mean glycosylated haemoglobin (HbA1) values were at the upper end (mean +/- 1SD, 8.1 +/- 1.1%) of the normal range (5.0-8.2%). Miglitol, an alpha-glucosidase inhibitor, given in a dose of 50 mg three times a day was studied in a double blind randomized crossover study. In diet and sulphonylurea treated patients, a mean 25% reduction of the post-prandial plasma glucose excursions was obtained whereas in ultralente treated patients miglitol appeared to reduce basal plasma glucose levels (p < 0.006). Side effects were limited to minor gastrointestinal disturbances, usually ameliorating after the first week of therapy. Alpha-glucosidase inhibition to prevent post-prandial glycaemia may have a role in patients in whom sulphonylurea or diet therapy has been used to obtain normal basal glucose concentrations.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • 1-Deoxynojirimycin / analogs & derivatives
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Body Weight / drug effects
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diet, Diabetic
  • Eating*
  • Female
  • Fructosamine
  • Glucosamine / analogs & derivatives*
  • Glucosamine / therapeutic use
  • Glycated Hemoglobin A / analysis
  • Glycoside Hydrolase Inhibitors*
  • Hexosamines / blood
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Imino Pyranoses
  • Insulin / therapeutic use
  • Insulin, Long-Acting / therapeutic use
  • Lipoproteins, HDL / blood
  • Lipoproteins, LDL / blood
  • Male
  • Middle Aged
  • Reference Values
  • Time Factors
  • Triglycerides / blood

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Glycoside Hydrolase Inhibitors
  • Hexosamines
  • Hypoglycemic Agents
  • Imino Pyranoses
  • Insulin
  • Insulin, Long-Acting
  • Lipoproteins, HDL
  • Lipoproteins, LDL
  • Triglycerides
  • miglitol
  • 1-Deoxynojirimycin
  • Fructosamine
  • Glucosamine