title: Concomitant use of miglitol and mitiglinide as initial combination therapy in type 2 diabetes mellitus.
abstract: OBJECTIVE
  To evaluate the efficacy of miglitol and mitiglinide alone or in combination on the metabolic profile and incretin secretion in Japanese type 2 diabetes patients.
  
  
  METHODS
  Patients on diet and exercise with or without metformin, were randomized to receive either miglitol, mitiglinide, or a combination, three times daily for 12 weeks.
  
  
  RESULTS
  At 12 weeks, HbA1c decreased significantly (p<0.001) and 1,5-AG increased significantly (p<0.001) in all three groups, with the greatest change seen with combination therapy. Effective improvement of postprandial hyperglycemia was demonstrated by a meal-loading test in all three interventions but serum insulin concentration was not increased by miglitol. In a subset of patients without prior metformin administration, faster and better glycemic control was achieved with the initial combination. After meal loading, serum total GLP-1 significantly increased only with miglitol monotherapy (p<0.05) and serum total GIP significantly decreased (p<0.01) in the arms employing miglitol after 12 weeks.
  
  
  CONCLUSIONS
  Miglitol/mitiglinide combination is more potent than monotherapy in improving glycemic control through the reduction of postprandial glucose excursion and the simultaneous sparing of additional insulin secretion. A marked difference in the effects of miglitol and mitiglinide on incretin secretion was also demonstrated.
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Tatsumi
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan. Electronic address: hashira@med.kawasaki-m.ac.jp.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Hashiramoto
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Hirukawa
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Shimoda
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Tawaramoto
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kanda-Kimura
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Anno
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kawasaki
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Tomoatsu
authors.initials: T
authors.lastname: Mune
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Matsuki
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Kaku
mesh_terms: D017485:1-Deoxynojirimycin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D004338:Drug Combinations; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D054833:Isoindoles / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D011379:Prognosis
chemical_list: D017485:1-Deoxynojirimycin; D015415:Biomarkers; D001786:Blood Glucose; D004338:Drug Combinations; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D054833:Isoindoles; D008687:Metformin; C517652:hemoglobin A1c protein, human; C045621:miglitol; C087255:mitiglinide