Alpha glucosidase inhibition in the treatment of non-insulin-dependent diabetes mellitus.
Two studies of the new alpha-glucosidase inhibitor, miglitol, in patients with non-insulin-dependent diabetes mellitus (NIDDM) are reported. In the first, 13 patients, poorly controlled on sulphonylureas, received miglitol 50mg three times daily for 4 weeks. Post-prandial blood glucose was reduced after breakfast, lunch, and tea compared with placebo (p less than 0.05-0.01) but there was no improvement in fasting blood glucose, serum fructosamine or haemoglobin A1. In a dose-response study the effect of a single dose of miglitol (0,50,100,150 or 200mg) on post-prandial glycaemia after a test breakfast was assessed in 20 patients with mean +/- SEM fasting blood glucose 9.9 +/- 0.4 mmol/l. With 50mg miglitol, there was a significant reduction in blood glucose from 30 to 120 min post-prandially compared with placebo. Increasing doses of miglitol further depressed the post-prandial rise in blood glucose and with 200mg there was no significant change from fasting levels. Side-effects were limited to flatus and loose stools particularly with the higher doses but were not severe. Miglitol effectively reduces post-prandial blood glucose rise in NIDDM with as little as 50mg but there is considerable individual variation. Larger doses may be necessary in patients already poorly controlled on sulphonylureas.
Scott
A R
AR
Queens Medical Centre, Nottingham, UK.
Tattersall
R B
RB
D017485:1-Deoxynojirimycin / Q000031:analogs & derivatives; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D050260:Carbohydrate Metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005944:Glucosamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D050112:Imino Pyranoses; D007328:Insulin / Q000097:blood; D007408:Intestinal Absorption / Q000187:drug effects; D008875:Middle Aged; D011897:Random Allocation
D001786:Blood Glucose; D065089:Glycoside Hydrolase Inhibitors; D050112:Imino Pyranoses; D007328:Insulin; C045621:miglitol; D017485:1-Deoxynojirimycin; D005944:Glucosamine