Miglitol suppresses the postprandial increase in interleukin 6 and enhances active glucagon-like peptide 1 secretion in viscerally obese subjects

Metabolism. 2008 Sep;57(9):1299-306. doi: 10.1016/j.metabol.2008.04.027.


Visceral obesity and insulin resistance are regarded as risk factors for atherosclerosis. Epidemiologic studies have demonstrated long-term anti-atherosclerotic effects with administration of alpha-glucosidase inhibitors. Alpha-glucosidase inhibitors also have been reported to enhance glucagon-like peptide 1 (GLP-1) secretion. We compared the postprandial effects of a single administration of miglitol and acarbose on glucose and lipid metabolism, on insulin requirement, on GLP-1 secretion, and on inflammatory and endothelial markers in viscerally obese subjects. Twenty-four viscerally obese subjects with relative insulin resistance participated in this study. Subjects were given a single dose of miglitol (50 mg), acarbose (100 mg), or placebo blindly and randomly before a meal in a crossover design. The meal loads after drug administration were tested 3 times within 2 weeks. We measured glucose, insulin, lipids, lipoprotein lipase, interleukin 6, intracellular adhesion molecule 1, vascular cell adhesion molecule 1, and active GLP-1 at before and various minutes after the meal. Single administration of both alpha-glucosidase inhibitors had several beneficial effects in improving postprandial hyperglycemia and reducing postprandial insulin requirement approximately 25% of placebo without adversely affecting lipid profiles. Although lipoprotein lipase levels within 2 hours after the meal did not show differences among miglitol, acarbose, and placebo administrations, miglitol significantly suppressed the increases in triglycerides, remnant-like particle triglycerides, and remnant-like particle cholesterol compared to acarbose and placebo in the early phase. Miglitol also significantly enhanced active GLP-1 secretion to a greater extent than acarbose (P < .01) and placebo (P < .001), and significantly suppressed the postprandial increase in interleukin 6 compared to placebo (P < .01). The results point to the potential suitability of miglitol as an anti-atherosclerotic effect in viscerally obese subjects, in preference to acarbose. Further studies are needed to elucidate the long-term effects on enhanced GLP-1 secretion and anti-atherosclerosis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • 1-Deoxynojirimycin / analogs & derivatives*
  • 1-Deoxynojirimycin / therapeutic use
  • Acarbose / therapeutic use
  • Adult
  • Blood Glucose / metabolism
  • Cross-Over Studies
  • Enzyme Inhibitors / therapeutic use*
  • Female
  • Glucagon-Like Peptide 1 / blood
  • Glucagon-Like Peptide 1 / metabolism*
  • Humans
  • Insulin / administration & dosage
  • Insulin / blood
  • Insulin / therapeutic use
  • Intercellular Adhesion Molecule-1 / blood
  • Interleukin-6 / antagonists & inhibitors*
  • Interleukin-6 / blood
  • Lipids / blood
  • Lipoprotein Lipase / blood
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / drug therapy
  • Obesity / metabolism*
  • Postprandial Period*
  • Single-Blind Method
  • Vascular Cell Adhesion Molecule-1 / blood
  • Viscera


  • Blood Glucose
  • Enzyme Inhibitors
  • Insulin
  • Interleukin-6
  • Lipids
  • Vascular Cell Adhesion Molecule-1
  • miglitol
  • Intercellular Adhesion Molecule-1
  • 1-Deoxynojirimycin
  • Glucagon-Like Peptide 1
  • Lipoprotein Lipase
  • Acarbose