Combination therapy of miglitol and insulin in type 1 diabetes mellitus patients.
Aims/Introduction:  Patients with type 1 diabetes mellitus often show a precipitous postprandial rise in blood glucose that cannot be controlled, even by intensive insulin therapy. The combined use of an α-glucosidase inhibitor with insulin seems to be highly beneficial in such cases.


METHODS
We investigated the efficacy and safety of miglitol, an α-glucosidase inhibitor, for 12 weeks in 43 type 1 diabetes patients on intensive insulin therapy.


RESULTS
Co-administration of miglitol resulted in only a modest and temporal decrease in HbA1c level. However, it resulted in a significant reduction of plasma glucose level after breakfast (250.7 ± 102.0 mg/dL at 2 h after breakfast before treatment; 212.0 ± 95.8 mg/dL at 2 h after breakfast after treatment for 12 weeks, P = 0.01) and a significant reduction of insulin dosage (41.6 ± 17.1 U/day before treatment; 39.8 ± 17.4 U/day 12 weeks after treatment, P < 0.001). During the study period, 88.4% (38/43) of subjects experienced hypoglycemia, but all events were mild except for one case, which was considered to be moderate. No unexpected adverse events were observed during the study period.


CONCLUSIONS
Co-administration of miglitol in type 1 diabetes patients on intensive insulin therapy resulted in an improvement of postprandial hyperglycemia with the reduction of insulin dosage. Considering the importance of postprandial hyperglycemia in the onset of cardiovascular disease, the combination therapy of miglitol and insulin could be advantageous in type 1 diabetes mellitus patients.
Department of Medicine, Metabolism & Endocrinology.
Sayaka
S
Kubo
Department of Medicine, Metabolism & Endocrinology ; Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Hirotaka
H
Watada
Department of Medicine, Metabolism & Endocrinology ; Center for Therapeutic Innovations in Diabetes ; Center for Beta Cell Biology and Regeneration ; Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Ryuzo
R
Kawamori
Insulin; Type 1 diabetes mellitus; α‐Glucosidase inhibitor