Effects of miglitol versus sitagliptin on postprandial glucose and lipoprotein metabolism in patients with type 2 diabetes mellitus

Kenta Okada; Hiroaki Yagyu; Kazuhiko Kotani; Hisataka Yamazaki; Kazufumi Ozaki; Manabu Takahashi; Shuichi Nagashima; Jun-ichi Osuga; Shun Ishibashi

doi:10.1507/endocrj.EJ13-0019

ORIGINALS

Effects of miglitol versus sitagliptin on postprandial glucose and lipoprotein metabolism in patients with type 2 diabetes mellitus

Kenta Okada, Hiroaki Yagyu, Kazuhiko Kotani, Hisataka Yamazaki, Kazufumi Ozaki, Manabu Takahashi, Shuichi Nagashima, Jun-ichi Osuga, Shun Ishibashi

Author information

Kenta Okada
Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan
Hiroaki Yagyu
Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan
Kazuhiko Kotani
Department of Public Health, Jichi Medical University, Tochigi 320-0498, Japan
Hisataka Yamazaki
Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan
Kazufumi Ozaki
Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan
Manabu Takahashi
Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan
Shuichi Nagashima
Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan
Jun-ichi Osuga
Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan
Shun Ishibashi
Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan

Keywords: α-Glucosidase inhibitor, Cookie-loading test, Dipeptidyl peptidase-4 inhibitor, Postprandial hyperglycemia, Postprandial hyperlipidemia

JOURNAL FREE ACCESS

2013 Volume 60 Issue 7 Pages 913-922

DOI https://doi.org/10.1507/endocrj.EJ13-0019

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Abstract

Postprandial hyperglycemia and/or hyperlipidemia can contribute to development of atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The objective of this study was to compare the effects of miglitol and sitagliptin on postprandial glucose and lipid metabolism in patients with T2DM. Thirty-five patients with T2DM were randomized to 2 groups receiving miglitol (150 mg/day) or sitagliptin (50 mg/day). Serum variables related to glucose and lipid metabolism were measured before and after treatment for 10 weeks and at 0, 60, and 120 min using a cookie-loading test (CLT). After 10 weeks of treatment, miglitol (n = 16) and sitagliptin (n = 18) caused a similarly significant decrease in hemoglobin A_1c (mean: 7.6% to 7.3% versus 8.0% to 7.6%) and a significant increase in fasting insulin levels, with a greater increase observed in the miglitol group than in the sitagliptin group (p=0.03). In addition, a significant decrease in the change in glucose levels after the CLT was observed in both groups, with a greater decrease observed in the miglitol group than in the sitagliptin group (p=0.02). The miglitol group also showed a greater decrease in the change in insulin levels after the CLT than the sitagliptin group (p<0.01). The lipid and lipoprotein levels did not show any significant differences between the groups after the CLT. Our results suggested that miglitol and sitagliptin treatment resulted in similar glycemic control but that a greater decrease in postprandial glucose and insulin levels was observed with miglitol compared with sitagliptin in patients with T2DM.

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