Acarbose controls postprandial hyperproinsulinemia in non-insulin dependent diabetes mellitus.
We investigated how fasting or postprandial insulin levels were altered by treatment with acarbose or sulfonylureas. Plasma glucose and serum insulin, C-peptide, and proinsulin levels were measured before as well as 1 and 2 h after breakfast in 23 patients with non-insulin-dependent diabetes mellitus and 17 patients with impaired glucose tolerance. In the diabetic patients, 12 weeks of acarbose therapy decreased the postprandial levels of glucose (1 h: -60.0%; 2 h: -67.6%), insulin (1 h: -67.5%; 2 h: -72.2%) and proinsulin (1 h: -55.2%; 2 h: -46.7%), and proinsulin (1 h: -20.9%; 2 h: -57.5%). In contrast, sulfonylurea treatment increased postprandial insulin and proinsulin levels. Since increased in the serum insulin or proinsulin levels are associated with a higher risk of cardiovascular disease, the present findings suggest that the acarbose-induced reduction of the postprandial serum insulin or proinsulin responses to food intake might be useful for preventing vascular complications in patients with diabetes.
Inoue
I
I
The Fourth Department of Internal Medicine, Saitama Medical School, Moroyama, Iruma-gun, Japan.
Takahashi
K
K
Noji
S
S
Awata
T
T
Negishi
K
K
Katayama
S
S
D020909:Acarbose; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002096:C-Peptide / Q000097:blood / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005215:Fasting; D005907:Gliclazide / Q000627:therapeutic use; D018149:Glucose Intolerance / Q000150:complications / Q000188:drug therapy; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D008875:Middle Aged; D019518:Postprandial Period; D011384:Proinsulin / Q000097:blood* / Q000187:drug effects*; D013997:Time Factors; D014044:Tolbutamide / Q000627:therapeutic use; D014280:Triglycerides / Q000097:blood; D014312:Trisaccharides / Q000627:therapeutic use*
D020909:Acarbose; D001786:Blood Glucose; D002096:C-Peptide; D002784:Cholesterol; D008076:Cholesterol, HDL; D005907:Gliclazide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D011384:Proinsulin; D014044:Tolbutamide; D014280:Triglycerides; D014312:Trisaccharides