Summary
Acarbose, an α-glucosidase inhibitor, delays starch digestion and inhibits intestinal sucrase and maltase activity. Twenty-eight insulin dependent diabetics were given Acarbose (3×100 mg daily) over a two month period, preceded and followed by a two month placebo period. Acarbose reduced post-break-fast and post-dinner blood glucose values by 25% (p <0.001) and 24% (p<0.05) respectively. It also significantly reduced mean daily blood glucose by 18% (p < 0.05) and mean amplitude of glycaemic excursions from 8.0±0.6 to 5.5±0.4 mmol/l (p<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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Schmidt DD, Frommer W, Junge B, Muller L, Wingender W, Truscheit E (1977) α-Glucosidase inhibitors. Naturwissenschaften 64: 535
Puls W, Keup U, Krause HP, Thomas G, Hoffmeister R (1977) Glucosidase inhibition. Naturwissenschaften 64: 536
Caspary WF (1978) Sucrose malabsorption in man after ingestion of α-glucosidehydrolase inhibitor. Lancet 1: 1231–1233
Caspary WF, Graf S (1979) Inhibition of human intestinal α- glucosidehydrolases by a new complex oligosaccharide. Res Exp Med 175: 1–6
Sachse G, Willms B (1979) Effect of the α-glucosidase inhibitor BAY-g-5421 on blood glucose control of sulphonylurea-treated diabetics and insulin-treated diabetics. Diabetologia 17: 287–290
Walton RJ, Sherif IT, Noy GA, Alberti KGMM (1979) Improved metabolic profiles in insulin-treated diabetic patients given an alpha-glucosidehydrolase inhibitor. Br Med J 1: 220–221
Laube Von H, Fouladfar M, Aubell R, Schmitz H (1980) Zur Wirkung des Glukosidasehemmers Bay g 5421 (Acarbose) auf das Blutzuckerverhallen bei adipösen Erwachsenendiabetikern. Arzneim Forsch 30: 1154–1157
Schmidt FH (1961) Enzymalic delermination of glucose and fructose simultaneously. Klin Wochenschr 39: 1244
Heding LG (1975) Radioimmunological determination of human C-peplide in serum. Diabetologia 11: 541–548
Schoos R, Schoos-Barbelte S, Lambolte C (1978) Dosage of hemoglobin A1c by isoelectrofocussing. Clin Chim Acta 86: 61–65
Service FJ, Molnar GD, Rosevear JW, Ackerman E, Gatewood LC, Taylor WF (1970) Mean amplitude of glycemic excursions, ameasure of diabetic inslabilily. Diabetes 19: 644–655
Schlichtkrall S, Munck O, Jersild M (1961) The M value, an index of blood sugar control in diabetics. Acta Med Scand 177: 95–99
Snedecor GW (1976) Statistical methods, 5th edn. Iowa State University Press, Ames
Jenkins DJA, Leeds AR, Wolever TMS, Goff D, Alberti KGMM, Gassul MA, Hockaday TDK (1976) Unabsorbable carbohydrates and diabetes: decreased post-prandial hyperglycaemia. Lancet 2: 172–174
Jenkins DJA, Taylor RH, Nineham R, Goff DV, Bloom SR, Sarson D, Alberti KGMM (1979) Combined use of guar and Acarbose in reduction of postprandial glycaemia. Lancet 2: 924–927
Jenkins DJA, Wolever TMS, Ninehma R, Sarson DL, Bloom SR, Ahem J, Alberti KGMM, Hockaday TDR (1980) Improved glucose tolerance four hours after taking guar with glucose. Diabetologia 19: 21–24
Jenkins DJA, Wolever TMS, Hockaday TDR, Leeds AR, Haworth R, Bacon S, Apling EC, Dilawari JB (1977) Treatment of diabetes with guar gum. Lancet 2: 779–780
Hillebrand I, Boehme K, Franck G, Fink H, Berchtold P (1979) The effects of the α-glucosidase inhibitor BAY g 5421 (Acarbose) on meal-stimulated elevations of circulating glucose, insulin and triglyceride levels in man. Res Exp Med 175: 81–86
Hillebrand I, Boehme K, Frank G, Fink H, Berchtold P (1979) The effects of the α-glucosidase inhibitor BAY g 5421 (Acarbose) on postprandial blood glucose, serum insulin, and triglyceride levels: dose-time-response relationships in man. Res Exp Med 175: 87–94
Caspary WF, Graf S (1979) Inhibition of human intestinal α- glucoside-hydrolases by a new complex oligosaccharide. Res Exp Med 175: 1–6
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Gérard, J., Luyckx, A.S. & Lefebvre, P.J. Improvement of metabolic control in insulin dependent diabetics treated with the α-glucosidase inhibitor Acarbose for two months. Diabetologia 21, 446–451 (1981). https://doi.org/10.1007/BF00257784
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DOI: https://doi.org/10.1007/BF00257784