Combined Use of Guar and Acarbose in Reduction of Postprandial Glycæmia

Jenkins, DavidJ.A.; Taylor, R.; Nineham, R.; Goff, D V; Bloom, S. R.; Sarson, D. L.; George, K.; Alberti, M.M.

doi:10.1016/s0140-6736(79)92622-9

Cited by 53 publications

(17 citation statements)

References 9 publications

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“…Earlier work on the inhibitor in man emphasized its anti-sucrase 8 and anti-glucoamylase activity in studies using sucrose challenges 7 ' 8 or mixed meals. 3 ' 16 One of these test meals was particularly low in sucrose 3 and yet acarbose was very effective in reducing the blood glucose and metabolite profiles of diabetic subjects who took specially prepared meals at set times while in the hospital. However, the aim of that study was not to examine the effect of substitution of starch for sucrose.…”

Section: Discussionmentioning

confidence: 99%

“…Where 50 mg acarbose was used, the meal contained a large amount of sucrose 16 and with the exception of a study on patients with the dumping syndrome, all have commented on symptoms attributable to carbohydrate malabsorption. 3>8<l6 In order to see whether the symptoms could be reduced, tests were done using a dose of acarbose that had been found sufficient to reduce the blood glucose response after taking sucrose but insufficient to cause significant carbohydrate malabsorption as judged by breath hydrogen evolution.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Acarbose on the 24-Hour Blood Glucose Profile and Pattern of Carbohydrate Absorption

et al. 1982

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Acarbose (Bay g 5421) is a powerful alpha-glucoside hydrolase inhibitor of potential value in the treatment of diabetes and hypoglycemic dumping syndrome after gastric surgery. The extent of its use may be limited by symptoms produced by carbohydrate malabsorption. To minimize these, the action of low doses of acarbose on 24-h blood glucose profiles and hydrogen evolution have been studied on four ambulant volunteers on control diets, after exclusion of sucrose and also after addition of guar in an attempt to enhance the therapeutic effect. Replacement of dietary sucrose by starch abolished significant hydrogen evolution in the morning after low doses of acarbose but did not reduce its effectiveness in decreasing the mean three-meal blood glucose area by 41% (P less than 0.002). Addition of hydrated guar to this diet reduced the mean three-meal glucose area after acarbose further by 72% (P less than 0.001) but increased hydrogen evolution. The results suggest that acarbose will be both effective and acceptable given at low dose when the dietary carbohydrate is starch.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of Acarbose on the 24-Hour Blood Glucose Profile and Pattern of Carbohydrate Absorption

et al. 1982

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“…Recently beneficial effects have been reported from the enrichment of food with naturally occurring fibre, such as guars and pectins [14][15][16][17]. A new approach has been developed by the isolation of complex oligosaccharides of microbial origin possessing a-glucosidase inhibitory properties.…”

Section: Discussionmentioning

confidence: 99%

Improvement of metabolic control in insulin dependent diabetics treated with the ?-glucosidase inhibitor Acarbose for two months

1981

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Summary. Acarbose, an a-glucosidase inhibitor, delays starch digestion and inhibits intestinal sucrase and maltase activity. Twenty-eight insulin dependent diabetics were given Acarbose (3 x 100 mg daily) over a two month period, preceded and followed by a two month placebo period. Acarbose reduced post-breakfast and post-dinner blood glucose values by 25% (p < 0.001) and 24% (p < 0.05) respectively. It also significantly reduced mean daily blood glucose by 18% (p < 0.05) and mean amplitude of glycaemic excursions from 8.0 _+ 0.6 to 5.5 + 0.4 mmol/1 (p <0.0005). Weight did not change significantly. Daily caloric and carbohydrate intake remained constant throughout the study while insulin requirements decreased slightly but significantly. Out of the 28 patients, 18 had absent while ten had slight residual B cell function as assessed by plasma C-peptide measurements. Treatment with Acarbose did not significantly affect residual B cell function. The beneficial effect of Acarbose on blood glucose control was seen in patients both with and without residual B cell secretion. The major side-effect was flatulence which was never severe enough to interrupt treatment, but led to a 50% reduction of the dose in one patient. It is concluded that Acarbose represents a useful additional means of improving metabolic control in insulin dependent diabetics.

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“…Although ginseng has been shown to inhibit gastric secretion in rats (28) and decrease glucose and maltose absorption in isolated rat and human duodenal samples (29), if AG was slowing digestion, then we would have expected lower values during the first 15 min of our study. This observation is typical with soluble dietary fiber (30) and acarbose (31,32), both of which operate through delaying or inhibiting the absorption of carbohydrates in the gut. Stronger support is therefore offered for a ginseng-modulating effect on insulin sensitization and secretion.…”

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confidence: 86%

Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes.

et al. 2000

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OBJECTIVE -We previously demonstrated that 3 g American ginseng (AG) reduced postprandial glycemia (PPG) in type 2 diabetic individuals. We investigated whether further reductions can be achieved with escalation of dose and time of AG administration.RESEARCH DESIGN AND METHODS -Ten type 2 diabetic patients (6 men, 4 women; age 63 ± 2 years; BMI 27.7 ± 1.5 kg/m 2 ; HbA 1c 7.3 ± 0.3%) were randomly administered 0 g (placebo) or 3, 6, or 9 g ground AG root in capsules at 120, 80, 40, or 0 min before a 25-g oral glucose challenge. Capillary blood glucose was measured before ingestion of AG or placebo and at 0, 15, 30, 45, 60, 90, and 120 min from the start of the glucose challenge.RESULTS -Two-way analysis of variance (ANOVA) demonstrated that treatment (0, 3, 6, and 9 g AG) but not time of administration (120, 80, 40, or 0 min before the challenge) significantly affected PPG (P Ͻ 0.05), with significant (P = 0.037) interaction for area under the curve (AUC). Pairwise comparisons showed that compared with 0 g (placebo), 3, 6, or 9 g significantly (P Ͻ 0.05) reduced AUC (19.7, 15.3, and 15.9%, respectively) and incremental glycemia at 30 min (16.3, 18.4, and 18.4%, respectively), 45 min (12.5, 14.3, and 14.3%, respectively), and 120 min (59.1, 40.9, and 45.5%, respectively). However, pairwise comparisons showed no differences between the 3-, 6-, or 9-g doses and any of the times of administration.CONCLUSIONS -AG reduced PPG irrespective of dose and time of administration. No more than 3 g AG was required at any time in relation to the challenge to achieve reductions. Because these reductions included glycemia at the 2-h diagnostic end point, there may be implications for diabetes diagnosis and treatment.

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Combined Use of Guar and Acarbose in Reduction of Postprandial Glycæmia

Cited by 53 publications

References 9 publications

Effect of Acarbose on the 24-Hour Blood Glucose Profile and Pattern of Carbohydrate Absorption

Effect of Acarbose on the 24-Hour Blood Glucose Profile and Pattern of Carbohydrate Absorption

Improvement of metabolic control in insulin dependent diabetics treated with the ?-glucosidase inhibitor Acarbose for two months

Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes.

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