title: Switching α-glucosidase inhibitors to miglitol reduced glucose fluctuations and circulating cardiovascular disease risk factors in type 2 diabetic Japanese patients.
abstract: OBJECTIVE
  In this study we examined the effects of switching α-glucosidase inhibitors (α-GI) from acarbose or voglibose to miglitol on glucose fluctuations and circulating concentrations of cardiovascular disease risk factors, such as soluble adhesion molecules (sE-selectin, sICAM-1 and sVCAM-1), a chemokine monocyte chemoattractant protein (MCP)-1, plasminogen activator inhibitor-1, and fatty acid-binding protein 4, in type 2 diabetic patients for 3 months.
  
  
  METHODS
  We enrolled 47 Japanese patients with type 2 diabetes, with HbA1c levels with 7.26 ± 0.5 % (mean ± standard deviation), and who were treated with the highest approved dose of acarbose (100 mg/meal) or voglibose (0.3 mg/meal) in combination with insulin or sulfonylurea. Patients' prior α-GIs were switched to a medium dose of miglitol (50 mg/meal), and the new treatments were maintained for 3 months. Thirty-five patients who completed the 3-month study and provided serum samples were analyzed.
  
  
  RESULTS
  The switch to miglitol for 3 months did not affect HbA1c, fasting glucose, triglycerides, total-cholesterol or C-reactive protein levels, or result in any adverse events. Glucose fluctuations were significantly improved by the change in treatment (M-value: 10.54 ± 4.32 to 8.36 ± 2.54), while serum protein concentrations of MCP-1 (525.04 ± 288.06-428.11 ± 163.78 pg/mL) and sE-selectin (18.65 ± 9.77-14.50 ± 6.26 ng/mL) were suppressed.
  
  
  CONCLUSIONS
  Our results suggest that switching from acarbose or voglibose to miglitol for 3 months suppressed glucose fluctuations and serum protein levels of MCP-1 and sE-selectin in type 2 diabetic Japanese patients, with fewer adverse effects.
authors: Division of Engineering, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Kofu, Japan.
authors: Natsuyo
authors: N
authors: Hariya
authors: Kazuki
authors: K
authors: Mochizuki
authors: Seiya
authors: S
authors: Inoue
authors: Miyoko
authors: M
authors: Saito
authors: Masahiro
authors: M
authors: Fuchigami
authors: Toshinao
authors: T
authors: Goda
authors: Takeshi
authors: T
authors: Osonoi
mesh_terms: D017485:1-Deoxynojirimycin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D020909:Acarbose / Q000494:pharmacology / Q000627:therapeutic use; D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D018932:Chemokine CCL2 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D019040:E-Selectin / Q000097:blood; D005260:Female; D065089:Glycoside Hydrolase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D007294:Inositol / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D001786:Blood Glucose; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D019040:E-Selectin; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; C045621:miglitol; D017485:1-Deoxynojirimycin; D007294:Inositol; C102817:voglibose; D020909:Acarbose