Improvement of metabolic control in insulin dependent diabetics treated with the ?-glucosidase inhibitor Acarbose for two months
Open accessAbstract
Acarbose, an alpha-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 less than 0.001) and 24% (p less than 0.05) respectively. It also significantly reduced mean daily blood glucose by 18% (p less than 0.05) and mean amplitude of glycaemic excursions from 8.0 +/- 0.6 to 5.5 +/- 0.4 mmol/l (p less than 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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α-glucosidase inhibitors decelerate breakdown of starch into glucose in small intestine and decrease its bioavailability, reducing glucose entering blood and attenuating postprandial glucose excursions.
“A-glucosidase inhibitors, such as acarbose, miglitol and voglibose, not only decelerate the breakdown of starch into glucose in the small intestine but also decrease its bioavailability, resulting in reduced levels of glucose entering the blood stream and hence attenuated postprandial glucose excursions.365, 366, 367, 368, 369, 370”
From Pancreatic regulation of glucose homeostasis. (2016) · cites this paper as [366]
The Discussion (page not supplied) says acarbose inhibits starch digestion, and the Blood Glucose Daily Profiles section reports lower post-meal blood glucose. But the Discussion says it mainly delays rather than inhibits carbohydrate absorption and reports no malabsorption, so the claimed decrease in bioavailability is not supported; the paper also does not establish the mechanism for miglitol or voglibose. (LLM, conf=0.87)
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Napolitano, T. (2017) · theses.fr (ABES) · doi:10.70675/aaf52a4az6ce1z446czae57z0d918d5706d5
- Authors
- G�rard, J., Luyckx, A. S., & Lefebvre, P. J.
- Affiliations
- University of Liège (BE)
- Venue
- Diabetologia
- Published
- 1981-11
- Volume
- 21
- Issue
- 5
- Pages
- 446-51
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2055895517
- Cited by
- 59
- References
- 20
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 1 · 2017: 1 · 2016: 1 · 2013: 1
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- acarbose, alpha-glucosidase inhibitors, type 1 diabetes, glycemic control, postprandial hyperglycemia, glycaemic excursions, residual beta-cell function, C-peptide, insulin requirement, flatulence, carbohydrate digestion
- MeSH terms
- Adult, Blood Glucose, C-Peptide, Diabetes Mellitus, Female, Glucosidases, Humans, Insulin, Islets of Langerhans, Male, Middle Aged, Oligosaccharides, Time Factors, Trisaccharides, Acarbose, Glycoside Hydrolase Inhibitors
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