Abstract
Two alpha-glucosidase inhibitors (α-GIs), acarbose and voglibose, have been used to treat patients with type 2 diabetes in Japan, and a new α-GI, miglitol, became available for clinical use in 2006. Postprandial hyperglycemia and postprandial hyperlipidemia have been found to be closely related to cardiovascular disease. Test meal A was developed to simultaneously evaluate postprandial hyperglycemia and hyperlipidemia.
We evaluated the effects of miglitol and voglibose on postprandial plasma glucose and plasma insulin in 20 patients with type 2 diabetes after test meal A loading. Miglitol strongly suppressed the rapid rise of postprandial plasma glucose 0.5 to 1 hour after meal loading compared to voglibose. Changes and incremental AUC0-120 min of postprandial plasma insulin were decreased more significantly by miglitol than by voglibose.
We concluded that miglitol suppressed the rapid rise of postprandial plasma glucose more markedly than voglibose in type 2 diabetic patients, thus more strongly suppressing endogenous insulin secretion.