Document Detail


Effects of miglitol in combination with intensive insulin therapy on blood glucose control with special reference to incretin responses in type 1 diabetes mellitus.
MedLine Citation:
PMID:  21869539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine whether miglitol administration improves glycemic control and reduces the frequency of hypoglycemia in type 1 diabetes mellitus (T1DM) patients treated with intensive insulin therapy, we analyzed the effect of miglitol on daily insulin doses, body weight, hypoglycemia, and incretin hormone responses during meal tolerance tests (MTT). Eleven T1DM subjects (21-77 years) undergoing intensive insulin therapy, took 25 mg (weeks 0-4) and 50 mg miglitol (weeks 4-12) thrice daily, immediately before meals. At weeks 0 and 12, 9 of 11 subjects underwent MTT. In present study, mean HbA1c, glycoalbumin, and 1,5-anhydroglucitol levels were significantly improved. The blood glucose level 1 h after dinner was significantly lower at week 12 than at week 0 (p = 0.008). From week 0 to 12, there was a significant decrease in the body mass index (BMI; p = 0.0051), frequency of preprandial hypoglycemic events (p = 0.012), and daily bolus insulin dosage (p = 0.018). The change in active glucagon-like peptide-1 (GLP-1) at 120 min significantly increased at week 12 (p = 0.015). The change in total glucose-dependent insulinotropic peptide (GIP) significantly decreased in the MTT at week 12. These results demonstrate that addition of miglitol on intensive insulin therapy in T1DM patients has beneficial effects on reducing BMI, bolus and total insulin dosage, and frequency of preprandial hypoglycemic events. MTT findings suggest that this combination therapy improves blood glucose control by delaying carbohydrate absorption and modifying the responses of incretins, GIP, and GLP-1.
Authors:
Etsuko Nagai; Tomoyuki Katsuno; Jun-Ichiro Miyagawa; Kosuke Konishi; Masayuki Miuchi; Fumihiro Ochi; Yoshiki Kusunoki; Masaru Tokuda; Kazuki Murai; Tomoya Hamaguchi; Mitsuyoshi Namba
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-08-26
Journal Detail:
Title:  Endocrine journal     Volume:  58     ISSN:  1348-4540     ISO Abbreviation:  Endocr. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-11-01     Completed Date:  2012-02-23     Revised Date:  2012-05-03    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  869-77     Citation Subset:  IM    
Affiliation:
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan. e-nagai@hyo-med.ac.jp
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MeSH Terms
Descriptor/Qualifier:
1-Deoxynojirimycin / administration & dosage,  adverse effects,  analogs & derivatives*,  therapeutic use
Adult
Aged
Deoxyglucose / blood
Diabetes Mellitus, Type 1 / blood,  drug therapy*
Drug Therapy, Combination / adverse effects
Enzyme Inhibitors / administration & dosage,  adverse effects,  therapeutic use
Gastric Inhibitory Polypeptide / blood
Glucagon-Like Peptide 1 / blood
Hemoglobin A, Glycosylated / analysis
Humans
Hyperglycemia / prevention & control*
Hypoglycemia / prevention & control*
Hypoglycemic Agents / administration & dosage,  adverse effects,  therapeutic use*
Incretins / blood*
Insulin / administration & dosage*,  adverse effects,  therapeutic use
Male
Middle Aged
Serum Albumin / analysis
Weight Loss / drug effects
Young Adult
alpha-Glucosidases / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Enzyme Inhibitors; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/Incretins; 0/Insulin; 0/Serum Albumin; 0/glycosylated serum albumin; 0/hemoglobin A1c protein, human; 154-17-6/Deoxyglucose; 154-58-5/1,5-anhydroglucitol; 19130-96-2/1-Deoxynojirimycin; 59392-49-3/Gastric Inhibitory Polypeptide; 72432-03-2/miglitol; 89750-14-1/Glucagon-Like Peptide 1; EC 3.2.1.20/alpha-Glucosidases

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