Alpha-Glucosidase Inhibitor - Explore the Science & Experts | ideXlab

Scan Science and Technology

Contact Leading Edge Experts & Companies

Alpha-Glucosidase Inhibitor

The Experts below are selected from a list of 228 Experts worldwide ranked by ideXlab platform

Alpha-Glucosidase Inhibitor – Free Register to Access Experts & Abstracts

C. Van Weel – One of the best experts on this subject based on the ideXlab platform.

  • Alpha-Glucosidase Inhibitors for Type 2 Diabetes Mellitus: A Systematic Review
    Chinese Journal of Evidence-Based Medicine, 2006
    Co-Authors: F.a. Van De Laar, P.l.b.j. Lucassen, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, C. Van Weel
    Abstract:

    Objectives To assess the effects of Alpha-Glucosidase Inhibitors in patients with type 2 diabdiabetes mellitus. Method We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials, Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Results We included 41 trials (8 130 participants), 30 investigated acarbose, seven mighty), one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.77% (95% confidence interval -0.90 to -0.64), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.32 mmol/L (95% confidence interval -2.73 to -1.92). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared in sulphonylurea. acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -84.5 to -81.8) respectively and acarbose caused more adverse effects. Conclusions It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when alphagJucvsidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated haemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

  • The Cochrane Library – Alpha-Glucosidase Inhibitors for type 2 diabetes mellitus
    The Cochrane database of systematic reviews, 2005
    Co-Authors: F.a. Van De Laar, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, Peter Lucassen, C. Van Weel
    Abstract:

    Background Alpha-Glucosidase Inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabdiabetes mellitus. The true value of these agents, especially in relation to diabetes related mortality and morbidity, has never been investigated in a systematic literature review and meta-analysis. Objectives To assess the effects of Alpha-Glucosidase Inhibitors in patients with type 2 diabdiabetes mellitus. Search methods We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials. Selection criteria Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Data collection and analysis Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Main results We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 to -0.7), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.3 mmol/L (95% confidence interval -2.7 to -1.9). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -184.5 to -81.8) respectively and acarbose caused more adverse effects. Authors’ conclusions It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when Alpha-Glucosidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

  • Alpha-Glucosidase Inhibitors for type 2 diabetes mellitus (Review)
    Cochrane Database of Systematic Reviews, 2005
    Co-Authors: F.a. Van De Laar, P.l.b.j. Lucassen, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, C. Van Weel
    Abstract:

    BACKGROUND: Alpha-Glucosidase Inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabdiabetes mellitus. The true value of these agents, especially in relation to diabetes related mortality and morbidity, has never been investigated in a systematic literature review and meta-analysis. OBJECTIVES: To assess the effects of Alpha-Glucosidase Inhibitors s in patients with type 2 diabdiabetes mellitus. SEARCH STRATEGY: We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials. Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). SELECTION CRITERIA: Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. DATA COLLECTION AND ANALYSIS: Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. MAIN RESULTS: We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 to -0.7), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.3 mmol/L (95% confidence interval -2.7 to -1.9). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -184.5 to -81.8) respectively and acarbose caused more adverse effects. AUTHORS’ CONCLUSIONS: It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when Alpha-Glucosidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

F.a. Van De Laar – One of the best experts on this subject based on the ideXlab platform.

  • Alpha-Glucosidase Inhibitors for Type 2 Diabetes Mellitus: A Systematic Review
    Chinese Journal of Evidence-Based Medicine, 2006
    Co-Authors: F.a. Van De Laar, P.l.b.j. Lucassen, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, C. Van Weel
    Abstract:

    Objectives To assess the effects of Alpha-Glucosidase Inhibitors in patients with type 2 diabetes mellitus. Method We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials, Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Results We included 41 trials (8 130 participants), 30 investigated acarbose, seven mighty), one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.77% (95% confidence interval -0.90 to -0.64), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.32 mmol/L (95% confidence interval -2.73 to -1.92). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared in sulphonylurea. acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -84.5 to -81.8) respectively and acarbose caused more adverse effects. Conclusions It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when alphagJucvsidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated haemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

  • The Cochrane Library – Alpha-Glucosidase Inhibitors for type 2 diabetes mellitus
    The Cochrane database of systematic reviews, 2005
    Co-Authors: F.a. Van De Laar, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, Peter Lucassen, C. Van Weel
    Abstract:

    Background Alpha-Glucosidase Inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabetes mellitus. The true value of these agents, especially in relation to diabetes related mortality and morbidity, has never been investigated in a systematic literature review and meta-analysis. Objectives To assess the effects of Alpha-Glucosidase Inhibitors in patients with type 2 diabetes mellitus. Search methods We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials. Selection criteria Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Data collection and analysis Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Main results We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 to -0.7), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.3 mmol/L (95% confidence interval -2.7 to -1.9). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -184.5 to -81.8) respectively and acarbose caused more adverse effects. Authors’ conclusions It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when Alpha-Glucosidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

  • Alpha-Glucosidase Inhibitors for type 2 diabetes mellitus (Review)
    Cochrane Database of Systematic Reviews, 2005
    Co-Authors: F.a. Van De Laar, P.l.b.j. Lucassen, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, C. Van Weel
    Abstract:

    BACKGROUND: Alpha-Glucosidase Inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabetes mellitus. The true value of these agents, especially in relation to diabetes related mortality and morbidity, has never been investigated in a systematic literature review and meta-analysis. OBJECTIVES: To assess the effects of Alpha-Glucosidase Inhibitors s in patients with type 2 diabetes mellitus. SEARCH STRATEGY: We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials. Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). SELECTION CRITERIA: Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. DATA COLLECTION AND ANALYSIS: Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. MAIN RESULTS: We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 to -0.7), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.3 mmol/L (95% confidence interval -2.7 to -1.9). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -184.5 to -81.8) respectively and acarbose caused more adverse effects. AUTHORS’ CONCLUSIONS: It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when Alpha-Glucosidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

Takashi Ibuka – One of the best experts on this subject based on the ideXlab platform.

  • Alpha-Glucosidase Inhibitor Voglibose Suppresses Azoxymethane-Induced Colonic Preneoplastic Lesions in Diabetic and Obese Mice
    International journal of molecular sciences, 2020
    Co-Authors: Junichi Kato, Yohei Shirakami, Taku Mizutani, Masaya Kubota, Hiroyasu Sakai, Takashi Ibuka, Masahito Shimizu
    Abstract:

    Type 2 diabdiabetes mellitus and its related insulin resistance are known to increase the risk of cancer. Anti-diabetic agents can improve insulin resistance and may lead to the suppression of carcinogenesis. This study aimed to investigate the preventive effects of the Alpha-Glucosidase Inhibitor voglibose on the development of azoxymethane-induced colorectal pre-neoplastic lesions in obese and diabetic C57BL/KsJ-db/db mice. The direct effects of voglibose on the proliferation of colorectal cancer cells were also evaluated. Mice were injected with azoxymethane to induce colorectal pre-malignancy and were then administered drinking water with or without voglibose. At the end of the study, the administration of voglibose significantly suppressed the development of colorectal neoplastic lesions. In voglibose-treated mice, serum glucose levels, oxidative stress, as well as mRNA expression of the insulin-like growth factor-1 in the colon mucomucosa, were reduced. The proliferation of human colorectal cancer cells was not altered by voglibose. These results suggested that voglibose suppressed colorectal carcinogenesis in a diabetes- and obesity-related colorectal cancer model, presumably by improving inflammation via the reduction of oxidative stress and suppressing of the insulin-like growth factor/insulin-like growth factor-1 receptor axis in the colonic mucosa.

  • Alpha-Glucosidase Inhibitor use is associated with decreased colorectal neoplasia risk in patients with type 2 diabetes mellitus receiving colonoscopy: a retrospective study
    Oncotarget, 2017
    Co-Authors: Yohei Horibe, Seiji Adachi, Tomohiko Ohno, Naoe Goto, Mitsuru Okuno, Midori Iwama, Osamu Yamauchi, Takao Kojima, Koshiro Saito, Takashi Ibuka
    Abstract:

    The purpose of this study was to clarify the factors that influence the incidence of colorectal neoplasia in patients with type 2 diabdiabetes mellitus (DM). Among a total of 1176 patients who underwent total colonoscopy at our hospital, we retrospectively analyzed 168 patients with type 2 DM. Univariate and multivariate logistic regression analyses were then performed to identify the risk factors associated with colorectal neoplasia. A multivariate analysis of these patients demonstrated that male gender (odds ratio [OR] = 4.04, 95% confidence interval [CI] = 1.67-10.37, p = 0.002), taking statins (OR = 4.59, 95% CI = 1.69-13.43, p = 0.003), taking alpha glucosidase Inhibitor (α-GI) (OR = 0.35, 95% CI = 0.13-0.87, p = 0.023) and taking low-dose aspirin (LDA) (OR = 0.32, 95% CI = 0.10-0.95, p = 0.040) were independent factors associated with an increased (male gender and statins) or decreased (α-GI and LDA) risk of colorectal neoplasia. While male gender and taking statins are risk factors, taking α-GI as well as LDA may reduce the risk of colorectal neoplasia in patients with type2 DM.

Guy E.h.m. Rutten – One of the best experts on this subject based on the ideXlab platform.

  • Alpha-Glucosidase Inhibitors for Type 2 Diabetes Mellitus: A Systematic Review
    Chinese Journal of Evidence-Based Medicine, 2006
    Co-Authors: F.a. Van De Laar, P.l.b.j. Lucassen, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, C. Van Weel
    Abstract:

    Objectives To assess the effects of Alpha-Glucosidase Inhibitors in patients with type 2 diabetes mellitus. Method We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials, Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Results We included 41 trials (8 130 participants), 30 investigated acarbose, seven mighty), one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.77% (95% confidence interval -0.90 to -0.64), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.32 mmol/L (95% confidence interval -2.73 to -1.92). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared in sulphonylurea. acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -84.5 to -81.8) respectively and acarbose caused more adverse effects. Conclusions It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when alphagJucvsidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated haemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

  • The Cochrane Library – Alpha-Glucosidase Inhibitors for type 2 diabetes mellitus
    The Cochrane database of systematic reviews, 2005
    Co-Authors: F.a. Van De Laar, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, Peter Lucassen, C. Van Weel
    Abstract:

    Background Alpha-Glucosidase Inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabetes mellitus. The true value of these agents, especially in relation to diabetes related mortality and morbidity, has never been investigated in a systematic literature review and meta-analysis. Objectives To assess the effects of Alpha-Glucosidase Inhibitors in patients with type 2 diabetes mellitus. Search methods We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials. Selection criteria Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Data collection and analysis Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Main results We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 to -0.7), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.3 mmol/L (95% confidence interval -2.7 to -1.9). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -184.5 to -81.8) respectively and acarbose caused more adverse effects. Authors’ conclusions It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when Alpha-Glucosidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

  • Alpha-Glucosidase Inhibitors for type 2 diabetes mellitus (Review)
    Cochrane Database of Systematic Reviews, 2005
    Co-Authors: F.a. Van De Laar, P.l.b.j. Lucassen, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, C. Van Weel
    Abstract:

    BACKGROUND: Alpha-Glucosidase Inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabetes mellitus. The true value of these agents, especially in relation to diabetes related mortality and morbidity, has never been investigated in a systematic literature review and meta-analysis. OBJECTIVES: To assess the effects of Alpha-Glucosidase Inhibitors s in patients with type 2 diabetes mellitus. SEARCH STRATEGY: We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials. Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). SELECTION CRITERIA: Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. DATA COLLECTION AND ANALYSIS: Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. MAIN RESULTS: We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 to -0.7), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.3 mmol/L (95% confidence interval -2.7 to -1.9). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -184.5 to -81.8) respectively and acarbose caused more adverse effects. AUTHORS’ CONCLUSIONS: It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when Alpha-Glucosidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

Reinier P. Akkermans – One of the best experts on this subject based on the ideXlab platform.

  • Alpha-Glucosidase Inhibitors for Type 2 Diabetes Mellitus: A Systematic Review
    Chinese Journal of Evidence-Based Medicine, 2006
    Co-Authors: F.a. Van De Laar, P.l.b.j. Lucassen, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, C. Van Weel
    Abstract:

    Objectives To assess the effects of Alpha-Glucosidase Inhibitors in patients with type 2 diabetes mellitus. Method We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials, Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Results We included 41 trials (8 130 participants), 30 investigated acarbose, seven mighty), one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.77% (95% confidence interval -0.90 to -0.64), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.32 mmol/L (95% confidence interval -2.73 to -1.92). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared in sulphonylurea. acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -84.5 to -81.8) respectively and acarbose caused more adverse effects. Conclusions It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when alphagJucvsidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated haemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

  • The Cochrane Library – Alpha-Glucosidase Inhibitors for type 2 diabetes mellitus
    The Cochrane database of systematic reviews, 2005
    Co-Authors: F.a. Van De Laar, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, Peter Lucassen, C. Van Weel
    Abstract:

    Background Alpha-Glucosidase Inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabetes mellitus. The true value of these agents, especially in relation to diabetes related mortality and morbidity, has never been investigated in a systematic literature review and meta-analysis. Objectives To assess the effects of Alpha-Glucosidase Inhibitors in patients with type 2 diabetes mellitus. Search methods We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials. Selection criteria Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Data collection and analysis Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Main results We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 to -0.7), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.3 mmol/L (95% confidence interval -2.7 to -1.9). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -184.5 to -81.8) respectively and acarbose caused more adverse effects. Authors’ conclusions It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when Alpha-Glucosidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.

  • Alpha-Glucosidase Inhibitors for type 2 diabetes mellitus (Review)
    Cochrane Database of Systematic Reviews, 2005
    Co-Authors: F.a. Van De Laar, P.l.b.j. Lucassen, Reinier P. Akkermans, E.h. Van De Lisdonk, Guy E.h.m. Rutten, C. Van Weel
    Abstract:

    BACKGROUND: Alpha-Glucosidase Inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabetes mellitus. The true value of these agents, especially in relation to diabetes related mortality and morbidity, has never been investigated in a systematic literature review and meta-analysis. OBJECTIVES: To assess the effects of Alpha-Glucosidase Inhibitors s in patients with type 2 diabetes mellitus. SEARCH STRATEGY: We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of Alpha-Glucosidase Inhibitors and we contacted experts and manufacturers for additional trials. Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). SELECTION CRITERIA: Randomised controlled trials of at least 12 weeks duration comparing Alpha-Glucosidase Inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. DATA COLLECTION AND ANALYSIS: Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. MAIN RESULTS: We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different Alpha-Glucosidase Inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 to -0.7), fasting blood glucose -1.1 mmol/L (95% confidence interval -1.4 to -0.9), post-load blood glucose -2.3 mmol/L (95% confidence interval -2.7 to -1.9). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by -24.8 pmol/L (95% confidence interval -43.3 to -6.3) and -133.2 pmol/L (95% confidence interval -184.5 to -81.8) respectively and acarbose caused more adverse effects. AUTHORS’ CONCLUSIONS: It remains unclear whether Alpha-Glucosidase Inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when Alpha-Glucosidase Inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead. Compared to sulphonylurea, Alpha-Glucosidase Inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.