Effects of miglitol in combination with intensive insulin therapy on blood glucose control with special reference to incretin responses in type 1 diabetes mellitus

Etsuko Nagai; Tomoyuki Katsuno; Jun-ichiro Miyagawa; Kosuke Konishi; Masayuki Miuchi; Fumihiro Ochi; Yoshiki Kusunoki; Masaru Tokuda; Kazuki Murai; Tomoya Hamaguchi; Mitsuyoshi Namba

doi:10.1507/endocrj.K11E-129

ORIGINALS

Effects of miglitol in combination with intensive insulin therapy on blood glucose control with special reference to incretin responses in type 1 diabetes mellitus

Etsuko Nagai, Tomoyuki Katsuno, Jun-ichiro Miyagawa, Kosuke Konishi, Masayuki Miuchi, Fumihiro Ochi, Yoshiki Kusunoki, Masaru Tokuda, Kazuki Murai, Tomoya Hamaguchi, Mitsuyoshi Namba

Author information

Etsuko Nagai
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Tomoyuki Katsuno
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Jun-ichiro Miyagawa
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Kosuke Konishi
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Masayuki Miuchi
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Fumihiro Ochi
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Yoshiki Kusunoki
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Masaru Tokuda
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Kazuki Murai
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Tomoya Hamaguchi
Division of Innovative Diabetes Treatment, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Mitsuyoshi Namba
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan

Keywords: Glucagon-like peptide-1 (GLP-1), Glucose-dependent insulinotropic peptide (GIP), Glucagon, Alpha-glucosidase inhibitor

JOURNAL FREE ACCESS

2011 Volume 58 Issue 10 Pages 869-877

DOI https://doi.org/10.1507/endocrj.K11E-129

View "Advance Publication" version (August 26, 2011).

Details

Abstract

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.

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