title: Glucagon-like peptide-1 response to acarbose in elderly type 2 diabetic subjects.
abstract: The anti-hyperglycemic effect of alpha-glucosidase inhibitors (AGI) is partly attributed to their ability to stimulate the secretion of glucagon-like peptide-1 (GLP-1), a gut hormone with insulin stimulating capability. To determine if this mechanism of action contributes significantly to the therapeutic efficacy of AGI in the elderly, 10 type 2 diabetic subjects over the age of 65 years were given a standardized test meal with or without 25, 50, or 100 mg acarbose. The serum glucose, insulin, triglycerides and GLP-1 levels were measured at baseline and at 1 and 2 h postprandially. The anti-hyperglycemic effect of acarbose was maximal at 25-mg dose under these experimental conditions. Serum postprandial insulin and triglycerides levels were not significantly altered with acarbose treatment. The postprandial serum GLP-1 levels rose significantly only in two subjects and only during treatment with 100-mg acarbose. There were no significant correlations between serum GLP-1 and serum glucose or insulin levels. It is concluded that in most elderly type 2 diabetic subjects, maximal anti-hyperglycemic effects can be achieved with relatively small doses of acarbose and that GLP-1 is unlikely to contribute to the clinical efficacy of this agent in this subgroup of subjects.
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Saint Louis University School of Medicine, 1402 South Grand Boulevard, St. Louis, MO 63104, USA.
authors.forename: Mary Jeanne
authors.initials: MJ
authors.lastname: DeLeon
authors.forename: Vikram
authors.initials: V
authors.lastname: Chandurkar
authors.forename: Stewart G
authors.initials: SG
authors.lastname: Albert
authors.forename: Arshag D
authors.initials: AD
authors.lastname: Mooradian
mesh_terms: D020909:Acarbose / Q000627:therapeutic use*; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004435:Eating; D005934:Glucagon / Q000097:blood* / Q000187:drug effects; D052216:Glucagon-Like Peptide 1; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood* / Q000187:drug effects; D019518:Postprandial Period; D011498:Protein Precursors / Q000097:blood* / Q000187:drug effects; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D010446:Peptide Fragments; D011498:Protein Precursors; D014280:Triglycerides; D052216:Glucagon-Like Peptide 1; D005934:Glucagon; D020909:Acarbose