Effect of additional administration of acarbose on blood glucose fluctuations and postprandial hyperglycemia in patients with type 2 diabetes mellitus under treatment with alogliptin

Yoshiki Kusunoki; Tomoyuki Katsuno; Makiko Myojin; Kana Miyakoshi; Takashi Ikawa; Toshihiro Matsuo; Fumihiro Ochi; Masaru Tokuda; Kazuki Murai; Masayuki Miuchi; Tomoya Hamaguchi; Jun-ichiro Miyagawa; Mitsuyoshi Namba

doi:10.1507/endocrj.EJ12-0290

ORIGINALS

Effect of additional administration of acarbose on blood glucose fluctuations and postprandial hyperglycemia in patients with type 2 diabetes mellitus under treatment with alogliptin

Yoshiki Kusunoki, Tomoyuki Katsuno, Makiko Myojin, Kana Miyakoshi, Takashi Ikawa, Toshihiro Matsuo, Fumihiro Ochi, Masaru Tokuda, Kazuki Murai, Masayuki Miuchi, Tomoya Hamaguchi, Jun-ichiro Miyagawa, Mitsuyoshi Namba

Author information

Yoshiki Kusunoki
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
Makiko Myojin
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Kana Miyakoshi
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Takashi Ikawa
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Toshihiro Matsuo
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
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
Masayuki Miuchi
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Tomoya Hamaguchi
Division of Innovative Diabetes Treatment, 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
Mitsuyoshi Namba
Division of Diabetes and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan
Division of Innovative Diabetes Treatment, Hyogo College of Medicine, Nishinomiya 663-8501, Japan

Keywords: Dipeptidyl peptidase-4 inhibitor, α-glucosidase inhibitor, Incretin hormones, Continuous glucose monitoring

JOURNAL FREE ACCESS

2013 Volume 60 Issue 4 Pages 431-439

DOI https://doi.org/10.1507/endocrj.EJ12-0290

Browse “Advance online publication” version

Details

Abstract

Acarbose was administered at 300 mg/day to patients with type 2 diabetes mellitus (T2DM) who had been taking 25 mg/day of alogliptin, and levels of blood glucose were analyzed by continuous glucose monitoring (CGM) for 3 days. The mean blood glucose level with acarbose (136.4 ± 30.7 mg/dL) did not differ significantly from that without acarbose (141.7 ± 28.3 mg/dL). However, in the condition of the combination therapy, there were significant decreases in the standard deviation of the mean blood glucose levels for the 24-hour period (27.6 ± 9.1 vs. 16.2 ± 6.9 mg/dL, p<0.001) and mean amplitude of glycemic excursions (MAGE) (65.8 ± 26.1 vs. 38.8 ± 19.2 mg/dL, p=0.010). In addition, a meal tolerance test was conducted to monitor changes in insulin secretion and active GLP-1 and total GIP values. Ten subjects (5 males, 5 females) of 54.9 ± 6.9 years with BMI 25.9 ± 5.2 kg/m² and HbAlc 9.2 ± 1.2% were enrolled. In the meal tolerance test, active GLP-1 values before and after acarbose administration were 17.0 ± 5.8 and 24.1 ± 9.3 pmol·hr/mL (p=0.054), respectively, showing an increasing tendency, and total GIP_AUC0-180 values were 685.9 ± 209.7 and 404.4 ± 173.7 pmol·hr/mL, respectively, showing a significant decrease (p=0.010). The results indicate that the combined administration of both inhibitors is effective not only in decreasing blood glucose fluctuations and preventing postprandial insulin secretion. The beneficial effects may also protect the endocrine pancreas and inhibit body weight gain.

Corresponding author

Register with J-STAGE for free!