[Current status of the treatment of type 2 diabetes mellitus. Alpha-glucosidase inhibitors].
The development of antidiabetic drugs with complementary mechanisms of action appears more and more necessary in order to achieve durable glycaemic control in type 2 diabetes. By inhibiting in a reversible way the hydrolysis of disaccharides and the ultimate steps of the digestion of dietary polysaccharides, alpha-glucosidase inhibitors reduce postprandial blood glucose raise in diabetics. This therapeutic class, limited in Europe until recently to acarbose, has been enlarged with the marketing of miglitol, whose pharmacokinetic properties might lead to better long term tolerance. The improvement of glycaemic control obtained with alpha-glucosidase inhibitors is now better evaluated and appears similar whatever the combinations with other antidiabetic drugs, including insulin. The role of alpha-glucosidase inhibitors in the overall therapeutic strategy of type 2 diabetes and their benefit on the evolution of long term complications remains to be clarified.
Blicklé
J F
JF
Service de médecine interne B, hôpital civil, hôpitaux universitaires de Strasbourg, France.
Andres
E
E
Brogard
J M
JM
D017485:1-Deoxynojirimycin / Q000031:analogs & derivatives; D020909:Acarbose / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004040:Dietary Carbohydrates / Q000378:metabolism; D004187:Disaccharides / Q000378:metabolism; D004338:Drug Combinations; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005944:Glucosamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D006868:Hydrolysis / Q000187:drug effects; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D050112:Imino Pyranoses; D007328:Insulin / Q000627:therapeutic use; D011134:Polysaccharides / Q000378:metabolism
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004187:Disaccharides; D004338:Drug Combinations; D004791:Enzyme Inhibitors; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D050112:Imino Pyranoses; D007328:Insulin; D011134:Polysaccharides; C045621:miglitol; D017485:1-Deoxynojirimycin; D005944:Glucosamine; D020909:Acarbose