Comparison of Adverse Gastrointestinal Effects of Acarbose and Miglitol in Healthy Men: A Crossover Study

Aoki, Kazutaka; Muraoka, Tomonori; Ito, Yuzuru; Togashi, Yuichi; Terauchi, Yasuo

doi:10.2169/internalmedicine.49.3218

Cited by 41 publications

(27 citation statements)

References 10 publications

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“…However, we previously reported that the administration of miglitol after a meal was equally effective as when administered just before a meal [7][8][9]. We also compared the adverse gastrointestinal effects of acarbose and miglitol and reported that the condition of the patient's stools and gastrointestinal symptoms should be taken into consideration when starting aGI therapy [10]. Such information may decrease adverse gastrointestinal effects.…”

Section: Introductionmentioning

confidence: 99%

Miglitol administered before breakfast increased plasma active glucagon-like peptide-1 (GLP-1) levels after lunch in patients with type 2 diabetes treated with sitagliptin

et al. 2011

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We recently reported that the administration of miglitol alone just before breakfast improved postprandial hyperglycemia and increased active glucagon-like peptide-1 (GLP-1) levels after lunch in men without diabetes. Miglitol and dipeptidyl peptidase-4 inhibitors, such as sitagliptin, enhance plasma active GLP-1 concentrations via different mechanisms; therefore, combined therapy with these agents was more effective than monotherapy. In this study, we compared the effectiveness of the administration of miglitol alone just before breakfast on the plasma glucose, serum insulin and glucagon, and plasma incretin levels in sitagliptin-treated patients with type 2 diabetes. We measured the plasma glucose, serum insulin and glucagon, plasma active GLP-1, and total glucose-dependent insulinotropic polypeptide levels before breakfast, at 120 min after breakfast, before lunch, and 60 and 120 min after lunch in patients with diabetes who are receiving sitagliptin. This trial was performed for the following 2 days on each subject (Day 1: no miglitol, Day 2: miglitol alone [50 mg] administered just before breakfast). The area under the curve (AUC) of the plasma glucose levels after lunch in the miglitol-treated group tended to be lower than that in the miglitol-untreated group, but the difference was not statistically significant. Miglitol alone administered at breakfast increased the AUC of the active plasma GLP-1 levels after lunch in sitagliptin-treated patients with diabetes. Our results suggest that the once-daily administration of miglitol as a "GLP-1 enhancer" in combination with sitagliptin was effective for the treatment for patients with diabetes.

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Section: Introductionmentioning

confidence: 99%

Miglitol administered before breakfast increased plasma active glucagon-like peptide-1 (GLP-1) levels after lunch in patients with type 2 diabetes treated with sitagliptin

et al. 2011

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“…European regulations suggest doses between 25 and 200 mg three times daily, depending on severity of disease (85) . Gastrointestinal side effects associated with acarbose have limited the success of the drug (86) . Administration of certain polyphenols may pose synergistic effects on sucrase and maltase activity (78)(79)(80)(81) depending on doses of polyphenol and acarbose (78) .…”

Section: Digestive Enzymes: In Vitro Studiesmentioning

confidence: 99%

Berries and anthocyanins: promising functional food ingredients with postprandial glycaemia-lowering effects

et al. 2016

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The prevalence of type 2 diabetes (T2D) is predicted to reach unprecedented levels in the next few decades. In addition to excess body weight, there may be other overlapping dietary drivers of impaired glucose homeostasis that are associated with an obesogenic diet, such as regular exposure to postprandial spikes in blood glucose arising from diets dominated by highly refined starches and added sugars. Strategies to reduce postprandial hyperglycaemia by optimising the functionality of foods would strengthen efforts to reduce the risk of T2D. Berry bioactives, including anthocyanins, are recognised for their inhibitory effects on carbohydrate digestion and glucose absorption. Regular consumption of berries has been associated with a reduction in the risk of T2D. This review aims to examine the evidence fromin vitro, animal and human studies, showing that berries and berry anthocyanins may act in the gut to modulate postprandial glycaemia. Specifically, berry extracts and anthocyanins inhibit the activities of pancreatic α-amylase and α-glucosidase in the gut lumen, and interact with intestinal sugar transporters, sodium-dependent glucose transporter 1 and GLUT2, to reduce the rate of glucose uptake into the circulation. Growing evidence from randomised controlled trials suggests that berry extracts, purées and nectars acutely inhibit postprandial glycaemia and insulinaemia following oral carbohydrate loads. Evidence to date presents a sound basis for exploring the potential for using berries/berry extracts as an additional stratagem to weight loss, adherence to dietary guidelines and increasing physical exercise, for the prevention of T2D.

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“…The sialic acid mimic, zanamivir (registered by GlaxoSmithKline), is widely used for clinical prevention and treatment of influenza by inhibiting the viral neuraminidase (24,25). Another monosaccharide mimic, miglitol, is designed mimicking the structure of glucose to inhibit the carbohydrate digestion activity of α-glucosidase (26)(27)(28). Miglitol has been used for the treatment of non-insulin-dependent-diabetes mellitus (NIDDM) since registered by Bayer in 1996.…”

Section: Carbohydrate Drugs Marketedmentioning

confidence: 99%

Carbohydrate drugs: current status and development prospect

Zhang

Wang

2015

DD&T

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Comparison of Adverse Gastrointestinal Effects of Acarbose and Miglitol in Healthy Men: A Crossover Study

Abstract: Objective

Cited by 41 publications

References 10 publications

Miglitol administered before breakfast increased plasma active glucagon-like peptide-1 (GLP-1) levels after lunch in patients with type 2 diabetes treated with sitagliptin

Miglitol administered before breakfast increased plasma active glucagon-like peptide-1 (GLP-1) levels after lunch in patients with type 2 diabetes treated with sitagliptin

Berries and anthocyanins: promising functional food ingredients with postprandial glycaemia-lowering effects

Carbohydrate drugs: current status and development prospect

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