Use of an alpha-glucosidase inhibitor to synchronize sugar absorption with delayed insulin secretion in a patient with non-insulin-dependent diabetes mellitus.
The case of a 67-year-old women with non-insulin-dependent diabetes mellitus is described. Diabetes was first diagnosed when the woman was aged 55; a diet of 1440 kcal daily was recommended and 500 mg tolbutamide daily was prescribed. Hypoglycaemia was improved for a while but the blood-sugar concentration gradually increased until a tolbutamide dose of 2000 mg/day was needed. The patient eventually came to an out-patient clinic for diabetes control due to continuous hyperglycaemia. Her diabetes proved difficult to control, probably due, in part, to excessive eating and lack of exercise, despite appropriate education and glibenclamide treatment. After 15 months, an alpha-glycosidase inhibitor, at a dosage of 0.75 mg/day, was added to the treatment with glibenclamide at 7.5 mg/day and the glycosylated haemoglobin level was reduced to normal levels within 2 months. After a further 6 months the glibenclamide dose was reduced to 3.75 mg/day with no ill effects during the subsequent 4 weeks, up to the present day.
Okada
S
S
Third Department of Internal Medicine, Okayama University Medical School, Japan.
Ishii
K
K
Tanokuchi
S
S
Hamada
H
H
Ichiki
K
K
Ota
Z
Z
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology*; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005905:Glyburide / Q000008:administration & dosage; D006442:Glycated Hemoglobin / Q000378:metabolism; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion
D001786:Blood Glucose; D004791:Enzyme Inhibitors; D005905:Glyburide; D006442:Glycated Hemoglobin; D065089:Glycoside Hydrolase Inhibitors; D007328:Insulin