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Alpha Glucosidase Inhibition in the Treatment of Non‐Insulin‐Dependent Diabetes Mellitus
Author(s) -
Scott A. R.,
Tattersall R. B.
Publication year - 1988
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1988.tb00939.x
Subject(s) - medicine , fructosamine , endocrinology , diabetes mellitus , placebo , postprandial , insulin , alternative medicine , pathology
Two studies of the new alpha‐glucosidase inhibitor, miglitol, in patients with non‐insulin‐dependent diabetes mellitus (NIDDM) are reported. In the first, 13 patients, poorly controlled on sulphonylureas, received miglitol 50mg three times daily for 4 weeks. Post‐prandial blood glucose was reduced after breakfast, lunch, and tea compared with placebo ( p <0.05–0.01) but there was no improvement in fasting blood glucose, serum fructosamine or haemoglobin A 1. In a dose‐response study the effect of a single dose of miglitol (0,50,100,150 or 200mg) on post‐prandial glycaemia after a test breakfast was assessed in 20 patients with mean ± SEM fasting blood glucose 9.9 ± 0.4 mmol/l. With 50mg miglitol, there was a significant reduction in blood glucose from 30 to 120 min post‐prandially compared with placebo. Increasing doses of miglitol further depressed the post‐prandial rise in blood glucose and with 200mg there was no significant change from fasting levels. Side‐effects were limited to flatus and loose stools particularly with the higher doses but were not severe. Miglitol effectively reduces post‐prandial blood glucose rise in NIDDM with as little as 50mg but there is considerable individual variation. Larger doses may be necessary in patients already poorly controlled on sulphonylureas.