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

Gérard, Jean-Louis; Luyckx, A; Lefèbvre, Pierre

doi:10.1007/bf00257784

Cited by 55 publications

(14 citation statements)

References 16 publications

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“…No previous study has examined the effect of acarbose on overnight blood glucose control, 23 although the reduction in fasting blood glucose concentration on acarbose was reported in one previous study. 22 It is thought 24 ' 25 that the major determinant of fasting blood glucose concentrations in IDDM is the level of free insulin between 0500 and 0700 h. In the present study there were wide interindividual and intraindividual variations in the free insulin profiles overnight, although the mean levels were comparable on all three occasions. It is therefore difficult to explain how acarbose reduced fasting blood glucose concentrations.…”

Section: Resultscontrasting

confidence: 59%

A New Approach to the Treatment of Nocturnal Hypoglycemia Using Alpha-Glucosidase Inhibition

McCulloch¹,

Kurtz

Tattersall³

1983

Diabetes Care

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Nocturnal hypoglycemia is common in the diabetic patient on twice-daily regular and intermediate (NPH or lente) insulin regimens because intermediate-acting insulins before the main evening meal produce "unopposed" free insulin peaks around 0300 h, food absorption having been completed much earlier. Fourteen insulin-dependent diabetic patients were treated for 6 wk with the alpha-glucosidase inhibitor, acarbose, in a double-blind crossover study to see whether the drug would delay absorption of the evening meal sufficiently to correct the mismatch and prevent nocturnal hypoglycemia. On 200 mg acarbose (six patients), inhibition of carbohydrate digestion was so profound as to lead to midevening hypoglycemia with severe flatulence and abdominal colic. With a smaller dose of 100 mg before the evening meal (eight patients) there was a significant reduction in MAGE and MBG coupled with a clinically significant reduction in midevening and nocturnal hypoglycemic reactions. Alpha-glucosidase inhibition therefore provides a promising new approach to the problem of nocturnal hypoglycemia although a preparation that is safe for long-term clinical use remains to be found.

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Section: Resultscontrasting

confidence: 59%

A New Approach to the Treatment of Nocturnal Hypoglycemia Using Alpha-Glucosidase Inhibition

McCulloch¹,

Kurtz

Tattersall³

1983

Diabetes Care

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“…Forty-eight hours later a 1. 6 MJ breakfast meal test was performed. The patient attended fasting at 0730 h when an IV cannula was inserted in a forearm vein.…”

Section: Part I One Month Cross-over Trialmentioning

confidence: 99%

Treatment of Poorly Controlled Non‐insulin‐dependent Diabetic Patients With Acarbose

Scott

Knowles

Beaven

1984

Australian and New Zealand Journal of Medicine

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Acarbose, 300 mg/day, was administered over one month in a cross-over trial to 18 hyperglycemic patients aged 41-66 years with non-insulin-dependent diabetes mellitus (NIDDM). All showed "normal" or exaggerated insulin release after a glucose challenge and remained in poor control (random glucose levels greater than or equal to 13 mmol/l) despite involvement in a diabetes intervention programme and prior use of oral hypoglycemic agents. During the one month treatment with Acarbose, fasting glucose and % HbAl concentrations were not different from those observed during placebo therapy. Furthermore, glucose tolerance was unchanged by Acarbose treatment. Glucose concentrations after a 1.6 MJ test meal were reduced by Acarbose from peak values of 17.3 +/- 1.0 to 15.0 +/- 1.1 mmol/l and were associated with lower post-prandial C-peptide (CPR) and insulin responses. Nevertheless, daily insulin production, as assessed by CPR excretion rates and plasma CPR and insulin concentrations, was not reduced by Acarbose. In fact, fasting plasma insulin and CPR levels were significantly higher during Acarbose then placebo therapy. Acarbose (100-400 mg/day) was continued for six months in 12 of these patients. During treatment, post-prandial glucose levels remained lower but monthly MBG values, determined by self-measurement of blood glucose, were unchanged except for small reductions in the 4th and 5th treatment months. % HbAl levels did not change. These data show that Acarbose treatment of a defined group of patients with poorly controlled NIDDM: resulted in small but sustained reductions of post-prandial glucose levels but without improving glucose tolerance, and reduced the circulating concentrations of insulin and CPR postprandially, but overall did not reduce daily production.

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“…In diabetic subjects, acarbose was shown to improve overall glycemic control and lipid profiles after longterm administration, but these studies were not placebo controlled (29)(30)(31). BAYm 1099 has been shown by serum fructosamine levels to have a minimal effect in improving glycemic control in a mixed group of diabetic subjects treated with diet alone, an oral hypoglycemic agent, or insulin (17).…”

Section: Table 3 Effects Of 4-wk Therapy With Baym 1099 or Placebo Onmentioning

confidence: 98%

Effects of BAYm 1099, New α-Glucosidase Inhibitor, on Acute Metabolic Responses and Metabolic Control in NIDDM Over 1 Mo

et al. 1988

Diabetes Care

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To examine the clinical role of BAYm 1099, 15 diet-treated non-insulin-dependent diabetic (NIDDM) subjects were randomized to start drug (50 mg 3 times/day) or placebo after a 4-wk run-in period in a double-blind crossover study. Treatment periods (4 wk) were separated by a 2-wk washout period. During the last week of each treatment period, three test meals (TMs) were administered: 60 g starch (TM1), 25 g sucrose (TM2), and combined 60 g starch and 25 g sucrose (TM3). Twelve subjects completed the study. The peak postprandial blood glucose, lactate, and pyruvate levels (means +/- SE) were significantly lower with active drug after all test meals, particularly TM2 (11.3 +/- 1.0 vs. 14.3 +/- 1.4 mM, P less than .001; 1.53 +/- 0.20 vs. 2.48 +/- 0.17 mM, P less than .001; and 105.1 +/- 17.6 vs. 147.6 +/- 11.1 microM, P less than) less than .001; and 105.1 +/- 17.6 vs. 147.6 +/- 11.1 microM, P less than .05, respectively. Peak blood glucose levels were significantly delayed. However, fasting blood glucose, HbA1, fructosamine, and cholesterol did not change during active treatment (10.0 +/- 1.0 vs. 9.9 +/- 1.0 mM, 10.0 +/- 0.7 vs. 9.4 +/- 0.7%, 2.44 +/- 0.10 vs. 2.37 +/- 0.07 mmol/100 g protein, and 6.7 +/- 0.3 vs. 6.5 +/- 0.3 mM, P NS). Flatulence and diarrhea were severe in 2 subjects, requiring termination of study. Thus, in NIDDM, BAYm 1099 was effective in diminishing and delaying postprandial excursions of blood glucose, lactate, and pyruvate after high- and low-sucrose meals, but overall metabolic control remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

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

Cited by 55 publications

References 16 publications

A New Approach to the Treatment of Nocturnal Hypoglycemia Using Alpha-Glucosidase Inhibition

A New Approach to the Treatment of Nocturnal Hypoglycemia Using Alpha-Glucosidase Inhibition

Treatment of Poorly Controlled Non‐insulin‐dependent Diabetic Patients With Acarbose

Effects of BAYm 1099, New α-Glucosidase Inhibitor, on Acute Metabolic Responses and Metabolic Control in NIDDM Over 1 Mo

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