title: Differential effects of α-glucosidase inhibitors on postprandial plasma glucose and lipid profile in patients with type 2 diabetes under control with insulin lispro mix 50/50.
abstract: BACKGROUND
  The additive effect of α-glucosidase inhibitors (α-GIs) was investigated in patients with type 2 diabetes (T2D) under control with rapid-acting insulin analog.
  
  
  METHODS
  Thirty-six poorly controlled T2D patients were recruited, and plasma glucose (PG) was controlled by three times daily injection of insulin lispro mix 50/50 (Mix50) to maintain fasting PG <130 mg/dL and 2-h postprandial PG (PPG) <180 mg/dL. Another group of 20 patients was randomly assigned to either 0.3 mg of voglibose or 50 mg of miglitol, which was administered at breakfast every other day. Another group of 16 patients was assigned to a crossover study, in which each α-GI was switched every day during the 6-day study. PPG, C-peptide, and lipid profile were analyzed.
  
  
  RESULTS
  The addition of voglibose had no effect on PPG, but miglitol blunted the PPG rise and significantly decreased 1-h and 2-h postprandial C-peptide levels compared with Mix50 alone. In addition, miglitol significantly decreased the 1-h postprandial triglyceride rise and the remnant-like particle-cholesterol rise, while it increased the 1-h postprandial high-density lipoprotein-cholesterol and apolipoprotein A-I levels in the crossover study.
  
  
  CONCLUSIONS
  Miglitol appears to have rapid action, which appears earlier than that of lispro. The combination of miglitol and Mix50 seems effective for the control of PPG and lipid profile in T2D.
authors.affiliation: Third Department of Internal Medicine, University of Fukui Faculty of Medical Science, Eiheiji, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kimura
authors.forename: Jinya
authors.initials: J
authors.lastname: Suzuki
authors.forename: Mai
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Michiko
authors.initials: M
authors.lastname: Imagawa
authors.forename: Satsuki
authors.initials: S
authors.lastname: Sato
authors.forename: Miki
authors.initials: M
authors.lastname: Fujii
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Zenimaru
authors.forename: Satoru
authors.initials: S
authors.lastname: Inaba
authors.forename: Sadao
authors.initials: S
authors.lastname: Takahashi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Konoshita
authors.forename: Isamu
authors.initials: I
authors.lastname: Miyamori
mesh_terms: D017485:1-Deoxynojirimycin / Q000031:analogs & derivatives* / Q000494:pharmacology; D016632:Apolipoprotein A-I / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004791:Enzyme Inhibitors / Q000494:pharmacology; D005260:Female; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007294:Inositol / Q000031:analogs & derivatives* / Q000494:pharmacology; D061268:Insulin Lispro / Q000494:pharmacology*; D008055:Lipids / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period / Q000187:drug effects*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D016632:Apolipoprotein A-I; D001786:Blood Glucose; D002096:C-Peptide; D004791:Enzyme Inhibitors; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D061268:Insulin Lispro; D008055:Lipids; D008075:Lipoproteins, HDL; D014280:Triglycerides; C045621:miglitol; D017485:1-Deoxynojirimycin; D007294:Inositol; C102817:voglibose