title: Effect of additional administration of acarbose on blood glucose fluctuations and postprandial hyperglycemia in patients with type 2 diabetes mellitus under treatment with alogliptin.
abstract: Acarbose was administered at 300 mg/day to patients with type 2 diabetes mellitus (T2DM) who had been taking 25 mg/day of alogliptin, and levels of blood glucose were analyzed by continuous glucose monitoring (CGM) for 3 days. The mean blood glucose level with acarbose (136.4 ± 30.7 mg/dL) did not differ significantly from that without acarbose (141.7 ± 28.3 mg/dL). However, in the condition of the combination therapy, there were significant decreases in the standard deviation of the mean blood glucose levels for the 24-hour period (27.6 ± 9.1 vs. 16.2 ± 6.9 mg/dL, p<0.001) and mean amplitude of glycemic excursions (MAGE) (65.8 ± 26.1 vs. 38.8 ± 19.2 mg/dL, p=0.010). In addition, a meal tolerance test was conducted to monitor changes in insulin secretion and active GLP-1 and total GIP values. Ten subjects (5 males, 5 females) of 54.9 ± 6.9 years with BMI 25.9 ± 5.2 kg/m² and HbAlc 9.2 ± 1.2% were enrolled. In the meal tolerance test, active GLP-1 values before and after acarbose administration were 17.0 ± 5.8 and 24.1 ± 9.3 pmol·hr/mL (p=0.054), respectively, showing an increasing tendency, and total GIP(AUC0-180) values were 685.9 ± 209.7 and 404.4 ± 173.7 pmol·hr/mL, respectively, showing a significant decrease (p=0.010). The results indicate that the combined administration of both inhibitors is effective not only in decreasing blood glucose fluctuations and preventing postprandial insulin secretion. The beneficial effects may also protect the endocrine pancreas and inhibit body weight gain.
authors.affiliation: Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan. ykusu@hyo-med.ac.jp
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kusunoki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Katsuno
authors.forename: Makiko
authors.initials: M
authors.lastname: Myojin
authors.forename: Kana
authors.initials: K
authors.lastname: Miyakoshi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ikawa
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Matsuo
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Ochi
authors.forename: Masaru
authors.initials: M
authors.lastname: Tokuda
authors.forename: Kazuki
authors.initials: K
authors.lastname: Murai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miuchi
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hamaguchi
authors.forename: Jun-ichiro
authors.initials: J
authors.lastname: Miyagawa
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Namba
mesh_terms: D020909:Acarbose / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control; D007328:Insulin / Q000097:blood / Q000378:metabolism; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D010880:Piperidines / Q000627:therapeutic use*; D014498:Uracil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015430:Weight Gain / Q000187:drug effects
chemical_list: D020909:Acarbose; D001786:Blood Glucose; D054873:Dipeptidyl-Peptidase IV Inhibitors; D004791:Enzyme Inhibitors; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D065089:Glycoside Hydrolase Inhibitors; D007328:Insulin; D010880:Piperidines; D014498:Uracil; C517652:hemoglobin A1c protein, human; C520853:alogliptin