title: Effects of combination therapy with mitiglinide and voglibose on postprandial plasma glucose in patients with type 2 diabetes mellitus.
abstract: Patients with diabetes mellitus are at increased risk from cardiovascular-related morbidity and mortality as compared with healthy individuals. An association between the postprandial metabolic state and atherogenesis has been observed in patients with diabetes mellitus. In the Study to Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM), treatment with an α-glucosidase inhibitor (α-GI) in patients with impaired glucose tolerance not only reduced the rate of conversion from impaired glucose tolerance to type 2 diabetes mellitus (T2DM), but was also associated with a reduction in the risk of cardiovascular events. These results suggested the importance of treating postprandial hyperglycemia in the early stages of T2DM. Glinides are rapid and short-acting insulin secretagogues that bind to the sulfonylurea receptors on pancreatic β-cells to facilitate rapid insulin secretion, restore postprandial early insulin secretion, and reduce the postprandial glucose spike. Moreover, α-GIs reduce postprandial hyperglycemia and insulin secretion by delaying the digestion of carbohydrates and polysaccharides in the small intestine. Then, both glinides and α-GI have beneficial effects for treating patients with T2DM and impaired glucose tolerance. Considering the ameliorating effects of these drugs on postprandial metabolic disorders, combinations of glinides and α-GI might constitute a promising therapeutic strategy for managing patients with T2DM, and also appear to be suitable for Japanese people, who consume more carbohydrates, such as polished rice, than Caucasians. It has recently been reported that combined use of mitiglinide and voglibose reduces postprandial insulin secretion and blunts diurnal glycemic changes in T2DM patients. This therapy can thus be regarded as being suitable for achieving strict postprandial glycemic control. In this report, we outline the effects of this combination therapy on postprandial plasma glucose and assess its safety.
authors.affiliation: Department of Internal Medicine, Ashiya Municipal Hospital, Ashiya, Hyogo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konya
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Katsuno
authors.forename: Taku
authors.initials: T
authors.lastname: Tsunoda
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Yano
authors.forename: Mai
authors.initials: M
authors.lastname: Kamitani
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
keywords: combination therapy; mitiglinide; postprandial hyperglycemia; type 2 diabetes mellitus; voglibose
references.citation: J Int Med Res. 2009 May-Jun;37(3):812-21
references.pmid: 19589264
references.citation: JAMA. 2003 Jul 23;290(4):486-94
references.pmid: 12876091
references.citation: Lipids Health Dis. 2009 Oct 12;8:41
references.pmid: 19821987
references.citation: Int Heart J. 2007 May;48(3):337-45
references.pmid: 17592198
references.citation: Diabetologia. 1984 Jan;26(1):44-9
references.pmid: 6368299
references.citation: Curr Drug Metab. 2011 Jan;12(1):57-69
references.pmid: 21303332
references.citation: Diabetes. 1977 Oct;26(10):944-52
references.pmid: 908463
references.citation: Diabetes Care. 1998 Mar;21(3):360-7
references.pmid: 9540016
references.citation: Metabolism. 2006 Jan;55(1):53-8
references.pmid: 16324919
references.citation: J Pharmacol Exp Ther. 1994 May;269(2):489-95
references.pmid: 8182516
references.citation: Diabetes Metab Res Rev. 2000 Mar-Apr;16(2):125-32
references.pmid: 10751752
references.citation: Endocrine. 2006 Apr;29(2):309-15
references.pmid: 16785606
references.citation: Diabet Med. 1998;15 Suppl 4:S63-8
references.pmid: 9868996
references.citation: Expert Opin Pharmacother. 2008 Oct;9(15):2691-8
references.pmid: 18803455
references.citation: Expert Opin Pharmacother. 2012 Nov;13(16):2257-68
references.pmid: 22994875
references.citation: Eur J Pharmacol. 2006 Feb 15;531(1-3):194-200
references.pmid: 16443212
references.citation: Cardiovasc Diabetol. 2010 Mar 24;9:12
references.pmid: 20334663
references.citation: J Int Med Res. 2009 Nov-Dec;37(6):1904-12
references.pmid: 20146890
references.citation: Curr Opin Lipidol. 1995 Oct;6(5):286-90
references.pmid: 8520851
references.citation: Metabolism. 2006 May;55(5 Suppl 1):S16-9
references.pmid: 16631805
references.citation: Ann Pharmacother. 2010 Oct;44(10):1615-23
references.pmid: 20841518
references.citation: Expert Opin Pharmacother. 2010 Feb;11(2):169-76
references.pmid: 20025554
references.citation: Lancet. 1999 Aug 21;354(9179):617-21
references.pmid: 10466661
references.citation: Diabetologia. 2005 Sep;48(9):1919-24
references.pmid: 16007412
references.citation: Curr Vasc Pharmacol. 2008 Oct;6(4):271-81
references.pmid: 18855715
references.citation: Endocr J. 2011;58(11):979-87
references.pmid: 21921362
references.citation: J Pharmacol Exp Ther. 2009 May;329(2):669-76
references.pmid: 19208898
references.citation: Lancet. 2009 May 9;373(9675):1607-14
references.pmid: 19395079
references.citation: Pharmacol Rev. 2008 Dec;60(4):470-512
references.pmid: 19074620
references.citation: Expert Opin Pharmacother. 2013 Mar;14(4):361-70
references.pmid: 23414242
references.citation: Diabetologia. 2001 Dec;44(12):2107-14
references.pmid: 11793012
references.citation: CMAJ. 2005 Jan 18;172(2):213-26
references.pmid: 15655244
references.citation: Cardiovasc Diabetol. 2011 Jul 14;10:66
references.pmid: 21756359
references.citation: Br J Nutr. 2007 Jul;98(1):32-7
references.pmid: 17367575
references.citation: Eur J Pharmacol. 1994 Nov 15;269(3):293-8
references.pmid: 7895769
references.citation: Eur J Pharmacol. 2001 Nov 9;431(1):119-25
references.pmid: 11716850
references.citation: Endocr J. 2010;57(7):579-86
references.pmid: 20467165
references.citation: J Med Invest. 2006 Aug;53(3-4):303-9
references.pmid: 16953069
references.citation: Diabetes. 1974 Feb;23(2):105-11
references.pmid: 4359625
references.citation: Cardiovasc Diabetol. 2012 Jun 29;11:79
references.pmid: 22748110
references.citation: Diabetes. 2004 Dec;53 Suppl 3:S156-64
references.pmid: 15561904
references.citation: Diabetes Res Clin Pract. 2002 Feb;55(2):99-103
references.pmid: 11796175
references.citation: Diabetes Obes Metab. 2012 Feb;14(2):130-8
references.pmid: 21923736
references.citation: Br J Pharmacol. 2001 Apr;132(7):1542-8
references.pmid: 11264248
references.citation: J Diabetes Investig. 2011 Jun 5;2(3):204-9
references.pmid: 24843485
references.citation: Circulation. 1979 Sep;60(3):473-85
references.pmid: 222498