Comparison of three α-glucosidase inhibitors for glycemic control and bodyweight reduction in Japanese patients with obese type 2 diabetes.
OBJECTIVE
α-Glucosidase inhibitors (αGIs) are widely used for the primary treatment of type 2 diabetes. We compared the clinical effects of three αGIs (miglitol, acarbose and voglibose) in patients with obese type 2 diabetes.


METHODS
Japanese patients (n = 81) with obese type 2 diabetes (body mass index [BMI] ≥25 kg/m(2)) were enrolled in this multicenter, open-label study. The participants were randomized into the miglitol (n = 18), acarbose (n = 22), voglibose (n = 19) or control (n = 22) groups. Glycemic control (fasting blood glucose and glycated hemoglobin [HbA1c]), bodyweight, BMI, serum insulin, serum lipids (low-density lipoprotein and high-density lipoprotein cholesterol, and triacylglycerols) and adipocytokines (leptin and adiponectin) were evaluated every 4 weeks for 12 weeks.


RESULTS
In the miglitol group, HbA1c was improved significantly from the baseline at all points. The changes in HbA1c at 8 and 12 weeks from baseline were greater in the miglitol group than the control group. The voglibose group showed significant improvements in HbA1c at 12 weeks. Bodyweight and BMI were decreased significantly in the miglitol group. In addition, significant correlations were observed between the decrements in HbA1c and bodyweights over 12 weeks in the miglitol (r = 0.759, P < 0.001) and voglibose groups (r = 0.667, P = 0.002). Serum lipid and adipocytokine levels were not altered in any groups.


CONCLUSIONS
αGIs, especially miglitol, can effectively control blood glucose and bodyweight in obese type 2 diabetes. This study was registered with UMIN (no. UMIN000006465).
Division of Endocrinology and Metabolism Department of Medicine Nippon Medical School Tokyo Japan.
Hitoshi
H
Sugihara
Division of Endocrinology and Metabolism Department of Medicine Nippon Medical School Tokyo Japan.
Mototsugu
M
Nagao
Division of Endocrinology and Metabolism Department of Medicine Nippon Medical School Tokyo Japan.
Taro
T
Harada
Division of Endocrinology and Metabolism Department of Medicine Nippon Medical School Tokyo Japan.
Yasushi
Y
Nakajima
Division of Endocrinology and Metabolism Department of Medicine Nippon Medical School Tokyo Japan.
Kyoko
K
Tanimura-Inagaki
Division of Endocrinology and Metabolism Department of Medicine Nippon Medical School Tokyo Japan.
Fumitaka
F
Okajima
Division of Endocrinology and Metabolism Department of Medicine Nippon Medical School Tokyo Japan.
Hideki
H
Tamura
Division of Endocrinology and Metabolism Department of Medicine Kashiwa City Hospital Kashiwa Japan.
Takeshi
T
Inazawa
Otonari Medical Clinic Fukuoka Japan.
Takatoshi
T
Otonari
Department of Medicine Saitama Medical Center Jichi Medical University Saitama Japan.
Masanobu
M
Kawakami
Division of Endocrinology and Metabolism Department of Medicine Nippon Medical School Tokyo Japan.
Shinichi
S
Oikawa
Bodyweight; Type 2 diabetes mellitus; α‐Glucoseidase inhibitor