An importance of carbohydrate ingestion for the expression of the effect of alpha-glucosidase inhibitor in NIDDM.
OBJECTIVE
To examine the usefulness of alpha-glucosidase inhibitors in glycemic control of patients with NIDDM. The involvement of carbohydrate ingestion in manifestation of the effects of alpha-glucosidase inhibitors was also investigated.


METHODS
A total of 41 patients hospitalized with NIDDM (22 patients receiving sulfonylurea and 19 receiving insulin therapy) were given alpha-glucosidase inhibitors during the period when their blood glucose levels were well controlled. They were followed for 3 weeks as inpatients and for an additional 6 months as outpatients. They were retrospectively divided into two groups according to the percentage of carbohydrates in all sources of calories during outpatient management: the < 50% group and the > 50% group. Between these two groups, we compared circadian variation in blood glucose levels, HbA1c, and urine C-peptide.


RESULTS
Treatment with alpha-glucosidase inhibitors during the hospital stay markedly improved circadian variation in blood glucose levels and HbA1c and decreased urine C-peptide in both groups. While HbA1c returned to its pretreatment level at 6 months after the treatment in the < 50% group, HbA1c had further improved in the > 50% group at 6 months.


CONCLUSIONS
alpha-Glucosidase inhibitors are useful for glycemic control in patients with NIDDM and the percentage of carbohydrate in all calorie sources is an important factor for the expression of their effects.
Hara
T
T
Third Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Nakamura
J
J
Koh
N
N
Sakakibara
F
F
Takeuchi
N
N
Hotta
N
N
D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002096:C-Peptide / Q000652:urine; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000652:urine; D004040:Dietary Carbohydrates; D002149:Energy Intake; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005905:Glyburide / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000032:analysis; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007297:Inpatients; D007328:Insulin / Q000627:therapeutic use; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D014044:Tolbutamide / Q000627:therapeutic use
D015415:Biomarkers; D001786:Blood Glucose; D002096:C-Peptide; D004040:Dietary Carbohydrates; D004791:Enzyme Inhibitors; D005905:Glyburide; D006442:Glycated Hemoglobin; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; D014044:Tolbutamide