Effect of the α-glucosidase inhibitor miglitol on the glucose profile in Japanese type 2 diabetic patients receiving multiple daily insulin injections.
Strict postprandial glycemic control may have a preventive effect on atherogenesis in patients with type 2 diabetes.  The α-glucosidase inhibitor (α-GI) miglitol is useful for controlling the early postprandial increase of glucose, but the combined effect of miglitol and multiple daily insulin injections (MDI) on glucose excursion has not been evaluated.  First, we retrospectively compared the daily glucose profile, evaluated by self-monitoring of blood glucose (SMBG) at nine times on the day before discharge from hospital, between type 2 diabetic patients receiving MDI (n=81) or MDI plus miglitol at 150 mg daily (n=24).  Second, we prospectively examined the effect of adding miglitol to MDI on the daily glucose profile (SMBG) in 19 other type 2 diabetic patients.  Although the daily insulin dosage and the glucose level before meals did not differ between the two groups, the 1-h postprandial glucose level after each meal, 2-h glucose level after lunch and dinner, mean and standard deviation of glucose, and amplitude of glucose excursion were significantly lower or smaller in the MDI plus miglitol group than in the MDI group.  All of these glucose parameters were significantly improved by adding miglitol to MDI in the prospective cohort of 19 patients.  In conclusion, adding miglitol to MDI reduces postprandial glucose levels and attenuates daily glucose fluctuation in type 2 diabetic patients.  This trial was registered with UMIN (no. UMIN000005383).
Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan.
Hiroyuki
H
Kato
Akio
A
Ohta
Suzuko
S
Kobayashi
Satoshi
S
Ishii
Yukiyoshi
Y
Sada
Hidetoshi
H
Kobayashi
Shintaro
S
Ohmori
Akihiko
A
Kondo
Takuyuki
T
Katabami
Junro
J
Fuse
Hisashi
H
Fukuda
Yoshio
Y
Nagai
Yasushi
Y
Tanaka
D017485:1-Deoxynojirimycin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D005260:Female; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D011446:Prospective Studies; D012189:Retrospective Studies
D001786:Blood Glucose; D004791:Enzyme Inhibitors; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; C045621:miglitol; D017485:1-Deoxynojirimycin