Effects of Miglitol, Acarbose, and Sitagliptin on Plasma Insulin and Gut Peptides in Type 2 Diabetes Mellitus: A Crossover Study
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INTRODUCTION: Both dipeptidyl peptidase-4 inhibitors and α-glucosidase inhibitors (α-GI) have been reported to change the incretin and insulin secretion. To examine the effects of acarbose, miglitol, and sitagliptin on glucose metabolism and secretion of gut peptides, we conducted a crossover study in patients with type 2 diabetes mellitus (T2DM). METHODS: Eleven Japanese patients with T2DM underwent four meal tolerance tests with single administration of acarbose, miglitol, sitagliptin, or nothing. Fasting and postprandial plasma levels of glucose, insulin, glucagon, active glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), ghrelin, and des-acyl ghrelin were measured. RESULTS: Early-phase insulin secretion was reduced following acarbose and miglitol, and the areas under the curve (AUC) of insulin at 180 min following acarbose and miglitol were significantly lower than sitagliptin. AUC of plasma glucose at 180 min after acarbose, miglitol, and sitagliptin tended to be lower than in controls, and plasma glucose levels at 30-60 min following miglitol were significantly lower than in controls. Plasma glucagon, ghrelin, and des-acyl ghrelin levels did not differ among the four conditions. Postprandial plasma active GLP-1 levels and AUC of GLP-1 increased significantly in both the sitagliptin and miglitol groups compared to control. Postprandial plasma total GIP levels increased following sitagliptin but decreased after acarbose and miglitol. Changes in incretin levels tended to be greater with miglitol than acarbose. CONCLUSION: These results showed that sitagliptin and α-GIs, miglitol more so than acarbose, improved hyperglycemia in patients with T2DM after single administration, and had different effects on insulin and incretin secretion. TRIAL REGISTRATION: UMIN-CTR number, UMIN000009981.
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GIP and glucagon levels decreased after mixed meal in patients with newly diagnosed type 2 diabetics by treatment with single-dose acarbose.
“There are studies that showed that he GIP and glucagon levels decreased after a mixed meal in patients with new diagnosed type 2 diabetics by treatment with single-dose acarbose[36, 37] and acarbose decreased GIP and glucagon only in a mixed meal test rather than OGTT.[38]”
From Postprandial Reactive Hypoglycemia (2019) · cites this paper as [37]
The Methods describe a single acarbose dose before a mixed-meal test, and Results > Gastrointestinal Peptides report lower GIP at 30 minutes than in controls. But Results > Glucose Metabolism report no difference in glucagon among conditions. Results > Baseline Characteristics also show diabetes durations of 3–24 years, so the participants were not newly diagnosed. (LLM, conf=0.92)
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- Authors
- Ueno, H., Tsuchimochi, W., Wang, H.-W., Yamashita, E., Tsubouchi, C., Nagamine, K., Sakoda, H., & Nakazato, M.
- Affiliations
- University of Miyazaki (JP)
- Corresponding author
- Nakazato, Masamitsu
- Venue
- Diabetes Therapy
- Published
- 2015-06
- Volume
- 6
- Issue
- 2
- Pages
- 187-196
- ISSN
- 1869-6953 (ISSN-L)
- 1869-6961
- PMC
- PMC4478179
- OpenAlex
- W1892082423
- Cited by
- 38
- References
- 37
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 1 · 2017: 2 · 2016: 3
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diabetes Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Grant-in-Aid for Clinical Research from Miyazaki University Hospital
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, miglitol, acarbose, sitagliptin, alpha-glucosidase inhibitors, DPP-4 inhibitors, insulin secretion, incretins, glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide, ghrelin, des-acyl ghrelin, glucagon, postprandial blood glucose, hyperglycemia
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