Post-prandial glycaemic reduction by an alpha-glucosidase inhibitor in type 2 diabetic patients with therapeutically attained basal normoglycaemia.
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.
Holman
R R
RR
Nuffield Department of Clinical Medicine, Radcliffe Infirmary, Oxford, UK.
Steemson
J
J
Turner
R C
RC
D017485:1-Deoxynojirimycin / Q000031:analogs & derivatives; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D003927:Diet, Diabetic; D004435:Eating; D005260:Female; D019270:Fructosamine; D005944:Glucosamine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000032:analysis; D065089:Glycoside Hydrolase Inhibitors; D006595:Hexosamines / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D050112:Imino Pyranoses; D007328:Insulin / Q000627:therapeutic use; D049528:Insulin, Long-Acting / Q000627:therapeutic use; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D017485:1-Deoxynojirimycin; D015415:Biomarkers; D001786:Blood Glucose; D019270:Fructosamine; D005944:Glucosamine; D006442:Glycated Hemoglobin; D065089:Glycoside Hydrolase Inhibitors; D006595:Hexosamines; D007004:Hypoglycemic Agents; D050112:Imino Pyranoses; D007328:Insulin; D049528:Insulin, Long-Acting; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; C045621:miglitol