Effects of alpha-glucosidase inhibition and viscous fibre on diabetic control and postprandial gut hormone responses.
Twelve sulphonylurea-treated Type 2 diabetic patients underwent treatment for 2-week periods with the absorbable alpha-glucosidase inhibitor BAY m1099 (50 mg thrice daily) and with guar granules (5 g thrice daily) separately and together in a sequence-randomized double-blind placebo-controlled study. BAY m1099 and guar reduced the mean fasting plasma glucose from 10.0 +/- 0.7 mmol l-1 to 8.7 +/- 0.5 (p less than 0.05) and 8.3 +/- 0.7 mmol l-1 (p less than 0.01), respectively. Both agents also lowered home-monitored postprandial blood glucose, with BAY m1099 exerting the greater effect. Guar, but not BAY m1099, lowered serum cholesterol from 5.43 +/- 0.52 to 5.29 +/- 0.31 mmol l-1 (p less than 0.05). BAY m1099 reduced the test breakfast plasma responses of glucose (p less than 0.001) and gastric inhibitory polypeptide (GIP, p less than 0.01) and increased those of peptide tyrosine-tyrosine (p less than 0.05) and motilin (p less than 0.01). Guar also reduced plasma glucose concentrations after a test breakfast (p less than 0.05) and increased the response of neurotensin (p less than 0.05). Combining treatments gave no further reduction of postprandial blood glucose concentration and was associated with an increased incidence and severity of gastrointestinal side-effects.
Requejo
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F
Servicio de Endocrinologia, Hospital Universitario San Carlos, Madrid, Spain.
Uttenthal
L O
LO
Bloom
S R
SR
D017485:1-Deoxynojirimycin / Q000031:analogs & derivatives; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004043:Dietary Fiber / Q000627:therapeutic use*; D004311:Double-Blind Method; D004435:Eating; D005260:Female; D019270:Fructosamine; D005685:Galactans / Q000627:therapeutic use*; D005944:Glucosamine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D065089:Glycoside Hydrolase Inhibitors; D006595:Hexosamines / Q000097:blood; D006801:Humans; D050112:Imino Pyranoses; D008297:Male; D008351:Mannans / Q000627:therapeutic use*; D008875:Middle Aged; D053149:Plant Gums; D011897:Random Allocation; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D001786:Blood Glucose; D004043:Dietary Fiber; D005685:Galactans; D065089:Glycoside Hydrolase Inhibitors; D006595:Hexosamines; D050112:Imino Pyranoses; D008351:Mannans; D053149:Plant Gums; D014280:Triglycerides; C045621:miglitol; D017485:1-Deoxynojirimycin; D019270:Fructosamine; D002784:Cholesterol; C007894:guar gum; D005944:Glucosamine