Effects of voglibose on glycemic excursions, insulin secretion, and insulin sensitivity in non-insulin-treated NIDDM patients.
OBJECTIVE
To investigate the effects of voglibose, an alpha-glucosidase inhibitor, on daily glycemic excursions, insulin secretion, and insulin sensitivity in non-insulin-treated NIDDM patients.


METHODS
An open prospective study was conducted in 27 NIDDM patients receiving diet therapy alone or treatment with a sulfonylurea drug. Of the study subjects, 14 patients were treated with voglibose; the remaining 13 patients served as the control group. The metabolic parameters were evaluated before treatment and at week 4 of treatment as follows: glycemic excursions by M-value and 1,5-anhydro-D-glucitol (1,5-AG), insulin secretion by area under the curve of daily serum insulin (AUCinsulin), and insulin sensitivity by the K index of the insulin tolerance test (KITT).


RESULTS
After the study treatment, HbA1c and plasma glucose in the patients who had received voglibose were comparable to those of patients in the control group. M-value was lower in the patients treated with voglibose than in the control subjects (5.7 +/- 0.9 vs. 9.8 +/- 1.2, P < 0.05). 1,5-AG was higher in the patients treated with voglibose than in the control subjects (12.2 +/- 1.0 vs. 8.2 +/- 0.7 micrograms/ml, P < 0.01). A statistically significant increase in AUCinsulin occurred after treatment with voglibose (2,223.5 +/- 390.6 to 1,546.7 +/- 303.4 pmol.l-1.h, P < 0.05), but no change occurred in the control group (2,364.5 +/- 315.4 to 2,464.2 +/- 269.3 pmol.l-1.h, P = 0.60). Insulin sensitivity (KITT) was improved to a statistically significant level in both the patients treated with voglibose and the patients in the control group. KITT in the patients after voglibose treatment was comparable to that of the control group (3.18 +/- 0.30 vs. 3.21 +/- 0.23%/min, P = 0.94).


CONCLUSIONS
The results suggest that voglibose lowers the daily glycemic excursions and inhibits overwork of the pancreatic beta-cells but has little effect on insulin sensitivity in NIDDM patients.
Matsumoto
K
K
Department of Internal Medicine, Sasebo Chuou Hospital, Nagasaki, Japan.
Yano
M
M
Miyake
S
S
Ueki
Y
Y
Yamaguchi
Y
Y
Akazawa
S
S
Tominaga
Y
Y
D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000188:drug therapy* / Q000378:metabolism; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D007294:Inositol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D002784:Cholesterol; D008076:Cholesterol, HDL; D004791:Enzyme Inhibitors; D005230:Fatty Acids, Nonesterified; D006442:Glycated Hemoglobin; D065089:Glycoside Hydrolase Inhibitors; D007294:Inositol; D007328:Insulin; D014280:Triglycerides; C102817:voglibose