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Yasuo Terauchi - One of the best experts on this subject based on the ideXlab platform.
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Comparison of Lipid-Lowering Effects of Anagliptin and Miglitol in Patients With Type 2 Diabetes: A Randomized Trial
Journal of clinical medicine research, 2020Co-Authors: Takahiro Iijima, Kazutaka Aoki, Yoshinobu Kondo, Yasuo TerauchiAbstract:Background: Recently, we reported that the level of lathosterol, a cholesterol synthesis marker, was suppressed after 1 month of treatment with anagliptin, a dipeptidyl peptidase-4 inhibitor. In this study, we administered either anagliptin or Miglitol, an alpha-glucosidase inhibitor, for 3 months in patients with type 2 diabetes and compared the lipid-lowering effects of anagliptin with those of Miglitol. Methods: This study was a 12-week, open-label, prospective, randomized, parallel-group comparison trial. Fifty-two patients with type 2 diabetes who aged 20 - 70 years with a low-density lipoprotein cholesterol (LDL-C) level of over 120 mg/dL, and with no history of treatment with antihyperlipidemic drugs were enrolled. Patients were randomly assigned to either the anagliptin group or Miglitol group. The 100 mg of anagliptin was administered twice a day for the anagliptin group and 50 mg of Miglitol was administered thrice a day for Miglitol group. The changes in lipids, cholesterol synthesis, and absorption markers were evaluated after 12 weeks. Results: Fifty-two participants were initially enrolled in the trial, and 47 of them completed the protocol. There was no significant difference in LDL-C, cholesterol synthesis, and the absorption markers between anagliptin and Miglitol groups. Conclusions: Anagliptin and Miglitol are similarly effective on lipid and glycemic control. J Clin Med Res. 2020;12(2):73-78 doi: https://doi.org/10.14740/jocmr4084
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Incretin Kinetics Before and After Miglitol in Japanese Patients With Late Dumping Syndrome
Journal of clinical medicine research, 2017Co-Authors: Mari Amagai, Hirohisa Tsuchiya, Yukari Chiba, Jun Suzuki, Jo Nagakura, Erina Shigematsu, Tadashi Yamakawa, Yasuo TerauchiAbstract:Background: In patients with late dumping syndrome following gastrectomy, it has been reported that hypoglycemia occurs due to inhibition of glucagon secretion as a result of excessive insulin production facilitated by an increase in glucagon-like peptide-1 (GLP-1). Methods: To determine the kinetics of incretins in Japanese patients with late dumping syndrome, an oral glucose tolerance test was carried out before and after Miglitol administration, and the kinetics of insulin and incretins were analyzed. Results: After Miglitol administration, there was improvement of hypoglycemia and early phase insulin secretion, with persistent excessive insulin secretion being minimized. These findings revealed that Miglitol inhibited rapid excessive influx of carbohydrates into the blood and persistent elevation of GLP-1, resulting in improvement of early phase insulin secretion and minimizing persistent excessive insulin secretion. Conclusions: Eating frequent small meals is generally effective for late dumping syndrome, but patients often find it difficult to continue such a regimen. Based on the present analysis of incretin kinetics, Miglitol may be a useful treatment option for late dumping syndrome. J Clin Med Res. 2017;9(10):879-885 doi: https://doi.org/10.14740/jocmr3135w
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Comparison of efficacy and safety of taking Miglitol dissolved in water during a meal and taking a Miglitol tablet just before a meal in patients with type 2 diabetes
Expert opinion on pharmacotherapy, 2016Co-Authors: Eriko Shibata, Kazutaka Aoki, Kazuki Tajima, Masataka Taguri, Yasuo TerauchiAbstract:ABSTRACTObjective: We compared the efficacy and safety of taking Miglitol dissolved in water during a meal and taking a Miglitol tablet just before a meal. Primary efficacy parameter is the area under the curve (AUC) for postprandial plasma glucose.Methods: Miglitol was administered according to three different intake schedules in each subject: intake schedule A, no Miglitol; intake schedule B, administration of Miglitol (50 mg) just before breakfast; intake schedule C, dissolving Miglitol (50 mg) in water and taking it just before (1/3), during (1/3), and just after breakfast (1/3). Blood samples were collected at 0, 30, 60, 120, and 180 min after breakfast.Results: The AUCs for plasma glucose, insulin, and total glucose-dependent insulinotropic polypeptide (GIP) were significantly lower for intake schedules B and C, compared with those for intake schedule A. The AUC for total glucagon like peptide-1(GLP-1) was higher for intake schedule C than for intake schedule A. The coefficient of variation (CV) of ...
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Miglitol administered before breakfast increased plasma active glucagon-like peptide-1 (GLP-1) levels after lunch in patients with type 2 diabetes treated with sitagliptin
Acta diabetologica, 2011Co-Authors: Kazutaka Aoki, Hiroshi Kamiyama, Kouichiro Yoshimura, Makoto Shibuya, Kiyomi Masuda, Yasuo TerauchiAbstract:We recently reported that the administration of Miglitol alone just before breakfast improved postprandial hyperglycemia and increased active glucagon-like peptide-1 (GLP-1) levels after lunch in men without diabetes. Miglitol and dipeptidyl peptidase-4 inhibitors, such as sitagliptin, enhance plasma active GLP-1 concentrations via different mechanisms; therefore, combined therapy with these agents was more effective than monotherapy. In this study, we compared the effectiveness of the administration of Miglitol alone just before breakfast on the plasma glucose, serum insulin and glucagon, and plasma incretin levels in sitagliptin-treated patients with type 2 diabetes. We measured the plasma glucose, serum insulin and glucagon, plasma active GLP-1, and total glucose-dependent insulinotropic polypeptide levels before breakfast, at 120 min after breakfast, before lunch, and 60 and 120 min after lunch in patients with diabetes who are receiving sitagliptin. This trial was performed for the following 2 days on each subject (Day 1: no Miglitol, Day 2: Miglitol alone [50 mg] administered just before breakfast). The area under the curve (AUC) of the plasma glucose levels after lunch in the Miglitol-treated group tended to be lower than that in the Miglitol-untreated group, but the difference was not statistically significant. Miglitol alone administered at breakfast increased the AUC of the active plasma GLP-1 levels after lunch in sitagliptin-treated patients with diabetes. Our results suggest that the once-daily administration of Miglitol as a “GLP-1 enhancer” in combination with sitagliptin was effective for the treatment for patients with diabetes.
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Comparison of adverse gastrointestinal effects of acarbose and Miglitol in healthy men: a crossover study.
Internal medicine (Tokyo Japan), 2010Co-Authors: Kazutaka Aoki, Tomonori Muraoka, Yuzuru Ito, Yu Togashi, Yasuo TerauchiAbstract:Objective The incidence of the gastrointestinal adverse effects is important to determine as these effects are the reason for lower compliance of α-glucosidase inhibitors (αGIs). There has been no direct investigation of the adverse effects with acarbose or Miglitol, therefore we compared them in healthy subjects. Methods Twenty-two healthy men were administered 75 mg of Miglitol or 100 mg of acarbose per every meal for three days. After four drug-free washout days, they were administered 100 mg of acarbose or 75 mg of Miglitol per every meal, respectively. They reported the state of their stool, borborygmi, abdominal bloating, flatus, and abdominal pain on the 1st and 3rd day. Results Stool tended to be soft when Miglitol was administered and to be firm when acarbose was administered. The flatus score of acarbose was greater than that of Miglitol. The abdominal bloating score of acarbose was greater than that of Miglitol on the 1st day. Conclusion Our results suggest that if diabetic patients have constipation, firm stool, or flatus they may be administered Miglitol and if they have diarrhea or soft stool they may be administered acarbose.
Kazutaka Aoki - One of the best experts on this subject based on the ideXlab platform.
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Comparison of Lipid-Lowering Effects of Anagliptin and Miglitol in Patients With Type 2 Diabetes: A Randomized Trial
Journal of clinical medicine research, 2020Co-Authors: Takahiro Iijima, Kazutaka Aoki, Yoshinobu Kondo, Yasuo TerauchiAbstract:Background: Recently, we reported that the level of lathosterol, a cholesterol synthesis marker, was suppressed after 1 month of treatment with anagliptin, a dipeptidyl peptidase-4 inhibitor. In this study, we administered either anagliptin or Miglitol, an alpha-glucosidase inhibitor, for 3 months in patients with type 2 diabetes and compared the lipid-lowering effects of anagliptin with those of Miglitol. Methods: This study was a 12-week, open-label, prospective, randomized, parallel-group comparison trial. Fifty-two patients with type 2 diabetes who aged 20 - 70 years with a low-density lipoprotein cholesterol (LDL-C) level of over 120 mg/dL, and with no history of treatment with antihyperlipidemic drugs were enrolled. Patients were randomly assigned to either the anagliptin group or Miglitol group. The 100 mg of anagliptin was administered twice a day for the anagliptin group and 50 mg of Miglitol was administered thrice a day for Miglitol group. The changes in lipids, cholesterol synthesis, and absorption markers were evaluated after 12 weeks. Results: Fifty-two participants were initially enrolled in the trial, and 47 of them completed the protocol. There was no significant difference in LDL-C, cholesterol synthesis, and the absorption markers between anagliptin and Miglitol groups. Conclusions: Anagliptin and Miglitol are similarly effective on lipid and glycemic control. J Clin Med Res. 2020;12(2):73-78 doi: https://doi.org/10.14740/jocmr4084
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Comparison of efficacy and safety of taking Miglitol dissolved in water during a meal and taking a Miglitol tablet just before a meal in patients with type 2 diabetes
Expert opinion on pharmacotherapy, 2016Co-Authors: Eriko Shibata, Kazutaka Aoki, Kazuki Tajima, Masataka Taguri, Yasuo TerauchiAbstract:ABSTRACTObjective: We compared the efficacy and safety of taking Miglitol dissolved in water during a meal and taking a Miglitol tablet just before a meal. Primary efficacy parameter is the area under the curve (AUC) for postprandial plasma glucose.Methods: Miglitol was administered according to three different intake schedules in each subject: intake schedule A, no Miglitol; intake schedule B, administration of Miglitol (50 mg) just before breakfast; intake schedule C, dissolving Miglitol (50 mg) in water and taking it just before (1/3), during (1/3), and just after breakfast (1/3). Blood samples were collected at 0, 30, 60, 120, and 180 min after breakfast.Results: The AUCs for plasma glucose, insulin, and total glucose-dependent insulinotropic polypeptide (GIP) were significantly lower for intake schedules B and C, compared with those for intake schedule A. The AUC for total glucagon like peptide-1(GLP-1) was higher for intake schedule C than for intake schedule A. The coefficient of variation (CV) of ...
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Miglitol administered before breakfast increased plasma active glucagon-like peptide-1 (GLP-1) levels after lunch in patients with type 2 diabetes treated with sitagliptin
Acta diabetologica, 2011Co-Authors: Kazutaka Aoki, Hiroshi Kamiyama, Kouichiro Yoshimura, Makoto Shibuya, Kiyomi Masuda, Yasuo TerauchiAbstract:We recently reported that the administration of Miglitol alone just before breakfast improved postprandial hyperglycemia and increased active glucagon-like peptide-1 (GLP-1) levels after lunch in men without diabetes. Miglitol and dipeptidyl peptidase-4 inhibitors, such as sitagliptin, enhance plasma active GLP-1 concentrations via different mechanisms; therefore, combined therapy with these agents was more effective than monotherapy. In this study, we compared the effectiveness of the administration of Miglitol alone just before breakfast on the plasma glucose, serum insulin and glucagon, and plasma incretin levels in sitagliptin-treated patients with type 2 diabetes. We measured the plasma glucose, serum insulin and glucagon, plasma active GLP-1, and total glucose-dependent insulinotropic polypeptide levels before breakfast, at 120 min after breakfast, before lunch, and 60 and 120 min after lunch in patients with diabetes who are receiving sitagliptin. This trial was performed for the following 2 days on each subject (Day 1: no Miglitol, Day 2: Miglitol alone [50 mg] administered just before breakfast). The area under the curve (AUC) of the plasma glucose levels after lunch in the Miglitol-treated group tended to be lower than that in the Miglitol-untreated group, but the difference was not statistically significant. Miglitol alone administered at breakfast increased the AUC of the active plasma GLP-1 levels after lunch in sitagliptin-treated patients with diabetes. Our results suggest that the once-daily administration of Miglitol as a “GLP-1 enhancer” in combination with sitagliptin was effective for the treatment for patients with diabetes.
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Comparison of adverse gastrointestinal effects of acarbose and Miglitol in healthy men: a crossover study.
Internal medicine (Tokyo Japan), 2010Co-Authors: Kazutaka Aoki, Tomonori Muraoka, Yuzuru Ito, Yu Togashi, Yasuo TerauchiAbstract:Objective The incidence of the gastrointestinal adverse effects is important to determine as these effects are the reason for lower compliance of α-glucosidase inhibitors (αGIs). There has been no direct investigation of the adverse effects with acarbose or Miglitol, therefore we compared them in healthy subjects. Methods Twenty-two healthy men were administered 75 mg of Miglitol or 100 mg of acarbose per every meal for three days. After four drug-free washout days, they were administered 100 mg of acarbose or 75 mg of Miglitol per every meal, respectively. They reported the state of their stool, borborygmi, abdominal bloating, flatus, and abdominal pain on the 1st and 3rd day. Results Stool tended to be soft when Miglitol was administered and to be firm when acarbose was administered. The flatus score of acarbose was greater than that of Miglitol. The abdominal bloating score of acarbose was greater than that of Miglitol on the 1st day. Conclusion Our results suggest that if diabetic patients have constipation, firm stool, or flatus they may be administered Miglitol and if they have diarrhea or soft stool they may be administered acarbose.
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Effects of pre-meal versus post-meal administration of Miglitol on plasma glucagon-like peptide-1 and glucosedependent insulinotropic polypeptide levels in healthy men
Endocrine journal, 2010Co-Authors: Kazutaka Aoki, Jo Nagakura, Yu Togashi, Takashi Miyazaki, Kazuki Orime, Yasuo TerauchiAbstract:We previously reported that the administration of Miglitol after a meal was equally effective as administration before a meal. Since glucagon-like peptide-1 (GLP-1) reportedly promotes islet cell growth and inhibits apoptosis in animal models, an increase in GLP-1 secretion might also be beneficial for islet cell function and mass in humans. Miglitol reportedly enhances GLP-1 responses and reduces glucose-dependent insulinotropic polypeptide (GIP). However, whether the effect of Miglitol on these incretins is comparable when Miglitol is administered before or after a meal remains uncertain. Here, we compared the effects of the pre-meal versus post-meal administration of Miglitol on the plasma active GLP-1 and total GIP levels in healthy men. Miglitol was administered according to three different intake schedules in each subject (control: no drug, intake 1: drug administered just before a meal [50 mg]; intake 2: drug administered at 30 min after the start of a meal [50 mg]). The area under the curve (AUC) of the plasma GLP-1 level for the intake 1 group was significantly greater than those of the control and intake 2 groups. The AUCs of the plasma GIP level for the intake 1 and 2 groups were significantly smaller than that of the control. The administration of Miglitol just before a meal, rather than after a meal, is recommended in view of the up-regulation of GLP-1.
Mitsuhiko Noda - One of the best experts on this subject based on the ideXlab platform.
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Additive effects of Miglitol and anagliptin on insulin-treated type 2 diabetes mellitus: a case study.
Clinical drug investigation, 2014Co-Authors: Miyako Kishimoto, Mitsuhiko NodaAbstract:The aim of this case study was to examine the efficacy of a dipeptidyl peptidase-4 inhibitor (anagliptin) and an α-glucosidase inhibitor (Miglitol) when added to ongoing insulin treatment in patients with type 2 diabetes mellitus. Continuous glucose monitoring was performed in four Japanese insulin-treated inpatients with type 2 diabetes. Baseline data were collected on day 1. Miglitol was administered on days 2 and 3. On day 4, Miglitol and anagliptin were coadministered before breakfast. On days 1, 3, and 5, blood was drawn for plasma glucose, serum C-peptide, plasma glucagon, total and active glucagon-like peptide-1 (GLP-1), and total and active glucose-dependent insulinotropic peptide (GIP) measurements. Coadministration of anagliptin with Miglitol resulted in additional improvements in glycemic control over the entire day in three of the four patients. The C-peptide, glucagon, and total and active GLP-1 and GIP responded differently to the medications for each patient, suggesting interindividual differences in hormonal responses, which may be complicated by multifactorial effects.
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CASE REPORT Additive Effects of Miglitol and Anagliptin on Insulin-Treated Type 2 Diabetes Mellitus: A Case Study
2014Co-Authors: Miyako Kishimoto, Mitsuhiko NodaAbstract:The Author(s) 2014. This article is published with open access at Springerlink.com Abstract The aim of this case study was to examine the efficacy of a dipeptidyl peptidase-4 inhibitor (anagliptin) and an a-glucosidase inhibitor (Miglitol) when added to ongoing insulin treatment in patients with type 2 diabetes mellitus. Continuous glucose monitoring was performed in four Japanese insulin-treated inpatients with type 2 diabe-tes. Baseline data were collected on day 1. Miglitol was administered on days 2 and 3. On day 4, Miglitol and anagliptin were coadministered before breakfast. On days 1, 3, and 5, blood was drawn for plasma glucose, serum C-peptide, plasma glucagon, total and active glucagon-like peptide-1 (GLP-1), and total and active glucose-dependent insulinotropic peptide (GIP) measurements. Coadminis-tration of anagliptin with Miglitol resulted in additional improvements in glycemic control over the entire day in three of the four patients. The C-peptide, glucagon, and total and active GLP-1 and GIP responded differently to the medications for each patient, suggesting interindividual differences in hormonal responses, which may be compli-cated by multifactorial effects. Key Points Administration of Miglitol to four patients with type 2 diabetes receiving ongoing insulin treatment showed beneficial effects on postprandial hyperglycemia. Based on the continuous glucose monitoring results, the coadministration of anagliptin with Miglitol resulted in additional improvements in glycemic control in three of the patients. C-peptide, glucagon, and total and active glucagon-like peptide-1 and glucose-dependent insulinotropic peptide responded differently to the study medications for each patient.
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Effect of the Addition of Sitagliptin and Miglitol on Insulin-Treated Type 2 Diabetes
Diabetes Therapy, 2012Co-Authors: Miyako Kishimoto, Mitsuhiko NodaAbstract:Introduction To examine the efficacy of sitagliptin and Miglitol when added to ongoing insulin treatment in a patient with type 2 diabetes who had undergone partial gastrectomy. Methods Continuous glucose monitoring (CGM) was performed and either sitagliptin or Miglitol, or both, were added to fixed-dose insulin therapy. Blood was drawn at 0, 30, 60, and 120 min after breakfast, and C-peptide, glucagon, glucagon-like peptide (GLP)-1, and glucose-dependent insulinotropic peptide (GIP) were measured. Results CGM showed that compared to insulin alone, the addition of either sitagliptin or Miglitol, or both, to insulin achieved better glucose control. Compared to insulin alone, early postprandial increments in plasma C-peptide levels and suppressed glucagon levels were observed when sitagliptin was added. Glucagon suppression was even more prominent when both sitagliptin and Miglitol were added. Compared to insulin alone, GLP-1 levels were higher during the early postprandial stage when sitagliptin or Miglitol was added and even higher when both were added. GIP levels decreased when sitagliptin or Miglitol, or both, were added to insulin therapy. Conclusion The authors showed that the addition of sitagliptin or Miglitol, or both, was effective in this insulin-treated patient with diabetes who had undergone gastrectomy.
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A pilot study of the efficacy of Miglitol and sitagliptin for type 2diabetes with a continuous glucose monitoring system and incretin-related markers
Cardiovascular diabetology, 2011Co-Authors: Miyako Kishimoto, Mitsuhiko NodaAbstract:Glucose fluctuations including robust postprandial hyperglycemia are a risk for promoting atherosclerosis and diabetic complications. The α-glucosidase inhibitors and the dipeptidyl peptidase-4 (DPP-4) inhibitors have been found to effectively decrease postprandial hyperglycemia independently. Therefore, glycemic control with the combination of these drugs is warranted. Continuous glucose monitoring (CGM) was performed for 3 patients with type 2 diabetes and 1 control subject from the beginning to the end of the study. Medications were not administered to any of the subjects on the first day of the study. From the second day to the end of study (days 2-5), the subjects received Miglitol (150 mg per day) and on days 4 and 5, sitagliptin (50 mg per day) was added to the treatment regimen. On the first, third, and fifth days of the study, blood was drawn at 0, 30, 60, 120, 180, and 240 min after breakfast for measurements of serum insulin, 1,5-anhydroglucitol (1,5-AG), plasma glucagon, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic peptide (GIP). Measurements of CGM and 1,5-AG levels showed that Miglitol attenuated the escalation and fluctuation of glucose levels, and this was even more pronounced with the combination of Miglitol and sitagliptin. The patterns of insulin secretion and glucagon secretion with Miglitol alone or with a combination of Miglitol and sitagliptin were various in the study subjects. Miglitol alone enhanced the release of GLP-1 in 1 patient with type 2 diabetes and the control subject, whereas the combination of Miglitol and sitagliptin increased GLP-1 levels to varying degrees in all the subjects. Except for 1 subject, none of the subjects showed any change in GIP levels after the addition of sitagliptin, compared to the administration of Miglitol alone. In conclusion, CGM measurements revealed that a combination of the α-GI Miglitol and the DPP-4 inhibitor sitagliptin effectively reduced postprandial glucose fluctuation and stabilized blood glucose levels. Completely different response patterns of insulin, glucagon, GLP-1, and GIP were observed among the study subjects with either medication alone or in combination, suggesting that individual hormone-dependent glycemic responses to the α-GI and DPP-4 inhibitors are complicated and multifactorial.
Hiroki Yokoyama - One of the best experts on this subject based on the ideXlab platform.
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comparisons of the effects of 12 week administration of Miglitol and voglibose on the responses of plasma incretins after a mixed meal in japanese type 2 diabetic patients
Diabetes Obesity and Metabolism, 2012Co-Authors: Takuma Narita, Hiroki Yokoyama, R. Yamashita, Takehiro Sato, Mihoko Hosoba, Tsukasa Morii, Hiroki Fujita, Katsushi Tsukiyama, Yuichiro YamadaAbstract:To compare the effects of Miglitol [an alpha-glucosidase inhibitor (AGI) absorbed in the intestine] and voglibose (an AGI not absorbed) on plasma glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) levels, 26 and 24 Japanese type 2 diabetic patients were randomly assigned to receive Miglitol or voglibose, respectively. After 12-week administration of both drugs, during 2-h meal tolerance test, plasma glucose, serum insulin and total GIP were significantly decreased and active GLP-1 was significantly increased. Miglitol group showed a significantly lower total GIP level than voglibose group. Miglitol, but not voglibose, significantly reduced body weight (BW). In all participants, the relative change in BW was positively correlated with that of insulin significantly and of GIP with a weak tendency, but not of GLP-1. In conclusion, both drugs can enhance postprandial GLP-1 responses and reduce GIP responses. The significant BW reduction by Miglitol might be attributable to its strong GIP-reducing efficacy.
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Comparisons of the effects of 12‐week administration of Miglitol and voglibose on the responses of plasma incretins after a mixed meal in Japanese type 2 diabetic patients
Diabetes obesity & metabolism, 2011Co-Authors: Takuma Narita, Hiroki Yokoyama, R. Yamashita, Takehiro Sato, Mihoko Hosoba, Tsukasa Morii, Hiroki Fujita, Katsushi Tsukiyama, Yuichiro YamadaAbstract:To compare the effects of Miglitol [an alpha-glucosidase inhibitor (AGI) absorbed in the intestine] and voglibose (an AGI not absorbed) on plasma glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) levels, 26 and 24 Japanese type 2 diabetic patients were randomly assigned to receive Miglitol or voglibose, respectively. After 12-week administration of both drugs, during 2-h meal tolerance test, plasma glucose, serum insulin and total GIP were significantly decreased and active GLP-1 was significantly increased. Miglitol group showed a significantly lower total GIP level than voglibose group. Miglitol, but not voglibose, significantly reduced body weight (BW). In all participants, the relative change in BW was positively correlated with that of insulin significantly and of GIP with a weak tendency, but not of GLP-1. In conclusion, both drugs can enhance postprandial GLP-1 responses and reduce GIP responses. The significant BW reduction by Miglitol might be attributable to its strong GIP-reducing efficacy.
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Elevated serum levels of interleukin-18 in patients with overt diabetic nephropathy: effects of Miglitol
Clinical and Experimental Nephrology, 2011Co-Authors: Takashi Uzu, Hiroki Yokoyama, Hirofumi Itoh, Daisuke Koya, Atsushi Nakagawa, Makoto Nishizawa, Hiroshi Maegawa, Yukiyo Yokomaku, Shin-ichi Araki, Atsuko AbikoAbstract:Background Interleukin-18 (IL-18), a pro-inflammatory cytokine, is a predictor of cardiovascular and renal disease in diabetic patients. Postprandial hyperglycemia is one of the important factors contributing to an increase in the circulating pro-inflammatory cytokine levels. This study investigated the effect of Miglitol, an α-glucosidase inhibitor, on postprandial hyperglycemia and IL-18 levels in diabetic patients with nephropathy. Methods Fifteen Japanese diabetic patients with persistent proteinuria and preserved renal function were recruited. The patients received 50 mg Miglitol thrice daily after the baseline examinations and were followed up for 12 weeks. A meal tolerance test was performed on eight patients at baseline and week 12. The fasting Miglitol concentration was measured in seven patients just before the meal tolerance test. Results There were no changes in the body weight, blood pressure, liver and renal function, and proteinuria from baseline to week 12. However, the levels of glycated hemoglobin and interleukin 18 significantly decreased from baseline to week 12. During the meal tolerance test, plasma glucose was significantly decreased 60 min after treatment with Miglitol, whereas the serum concentration of insulin was not changed. Fasting and postprandial levels of IL-18 were significantly decreased from baseline to week 12. Serum Miglitol concentrations showed a significantly negative correlation with eGFR ( r = −0.82, p = 0.02). However, the serum Miglitol concentrations did not changed during the course of this study. Conclusion Miglitol improved postprandial hyperglycemia and reduced serum IL-18 levels in patients with stage 3 diabetic nephropathy. Miglitol may therefore prevent atherosclerotic diseases and diabetic micro-vascular complications through decreasing glucose swings and/or the circulating IL-18 level.
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Effect of insulin-unstimulated diabetic therapy with Miglitol on serum cystatin C level and its clinical significance
Diabetes research and clinical practice, 2008Co-Authors: Hiroki Yokoyama, Teruo Inoue, Koichi NodeAbstract:Abstract The serum cystatin C level is thought to provide a more accurate estimate of renal function in diabetic subjects than creatinine-based methods. This study was designed to compare Miglitol and miglitinide, on cystatin C levels. Forty patients with type 2 diabetes were randomly assigned to receive 150 mg/day Miglitol or 30 mg/day mitiglinide. The serum cystatin C level was measured in 36 patients (19 in the Miglitol group and 17 in the mitiglinide group) undergoing meal tolerance testing. High sensitivity C reactive protein (hsCRP) was also assessed. After 3 months of therapy, the cystatin C level did not change but the log-transformed hsCRP value decreased (3.03 ± 0.32 to 2.83 ± 0.34 log[μg/L], P P
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Miglitol increases the adiponectin level and decreases urinary albumin excretion in patients with type 2 diabetes mellitus.
Metabolism: clinical and experimental, 2007Co-Authors: Hiroki Yokoyama, Sakiko Kannno, Ikue Ishimura, Koichi NodeAbstract:Postprandial hyperglycemia is associated with increased cardiovascular mortality; therefore, lowering postprandial hyperglycemia seems crucial in type 2 diabetes mellitus. We assessed the effect of 2 different postprandial glucose-lowering agents, the α-glucosidase inhibitor Miglitol and the meglitinide analogue mitiglinide, on metabolic profile and atherosclerosis-related markers. Glucose levels, insulin levels, lipid profile, serum adiponectin, pulse wave velocity (PWV), and urinary albumin excretion rate (AER) were assessed before and after 3 months in 28 patients with type 2 diabetes mellitus randomly allocated to either Miglitol 150 mg/d or mitiglinide 30 mg/d. Both agents improved postprandial glucose levels but exhibited different patterns of insulin levels. Body mass index (BMI) tended to decrease with Miglitol (P = .06), and homeostasis model assessment of insulin resistance and AER significantly decreased (P < .05 and P < .001, respectively) with Miglitol; these changes were not obtained with mitiglinide. Pulse wave velocity did not change. The 3-month changes in 1,5-anhydroglucitol levels were significantly more with Miglitol than with mitiglinide (P = .007). Adiponectin levels were significantly increased only with Miglitol (P < .01), and the 3-month changes were significantly more with Miglitol than with mitiglinide (P = .048). The significant increase in adiponectin by Miglitol was inversely correlated with the ratio of the 60-minute change in blood glucose at 3 months divided by the change at baseline (r = −0.59, P = .020), which was independent of the effect of age, sex, changes in hemoglobin A1c and BMI, and the baseline concentration of adiponectin. The present comparative study indicated favorable effects of Miglitol on BMI, homeostasis model assessment of insulin resistance, adiponectin, and AER, which are markers related to insulin resistance and atherosclerosis. Future studies are needed to elucidate the long-term effect.
Toshinao Goda - One of the best experts on this subject based on the ideXlab platform.
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cotreatment with the α glucosidase inhibitor Miglitol and dpp 4 inhibitor sitagliptin improves glycemic control and reduces the expressions of cvd risk factors in type 2 diabetic japanese patients
Metabolism-clinical and Experimental, 2014Co-Authors: Chihiro Imai, Toshinao Goda, Kazuki Mochizuki, Masahiro Fuchigami, Miyoko Saito, Takeshi OsonoiAbstract:Abstract Objective In this study, we examined whether inhibition of postprandial hyperglycemia by combination therapy with two drugs for reducing postprandial hyperglycemia, i.e., α-glucosidase inhibitor Miglitol and dipeptidyl peptidase (DPP)-4 inhibitor sitagliptin, improves glycemic control and reduces the risk of cardiovascular disease (CVD) development. Materials/Methods We enrolled 32 type 2 diabetic Japanese patients with hemoglobin A1c (HbA1c) levels ranging from 6.9% to 10.5%, who had been treated for at least 2 months with 50 mg Miglitol (t.i.d.) or 50 mg sitagliptin (q.d.). Following a monotherapy period with either Miglitol (Group-M) or sitagliptin (Group-S) for 1 month, the patients were subjected to combination therapy with sitagliptin and Miglitol for 3 months. Meal tolerance tests were performed at the end of the monotherapy and combination therapy. Results Combination therapy for 3 months after monotherapy reduced HbA1c (changes: Group-M: − 1.3% ± 0.7%, P Conclusions Our results suggest that combination therapy with Miglitol and sitagliptin improves glycemic control and reduces the circulating protein concentrations of IL-8, sE-selectin, and sVCAM-1 in type 2 diabetic Japanese patients.
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treatment with the α glucosidase inhibitor Miglitol from the preonset stage in otsuka long evans tokushima fatty rats improves glycemic control and reduces the expression of inflammatory cytokine genes in peripheral leukocytes
Metabolism-clinical and Experimental, 2011Co-Authors: Kazuki Mochizuki, Nanae Fukaya, Yutaro Tanaka, Masahiro Fuchigami, Toshinao GodaAbstract:Otsuka Long-Evans Tokushima Fatty (OLETF) rats, an animal model of type 2 diabetes mellitus, exhibit chronic and slowly progressive hyperglycemia with obesity. In this study, we examined whether dietary supplementation with the α-glucosidase inhibitor Miglitol from the preonset stage improves glycemic control and reduces the gene expression of inflammatory cytokines in peripheral leukocytes. The OLETF rats were fed a control diet or a diet containing 800 ppm Miglitol (Miglitol diet) for 40 weeks from 5 weeks of age (preonset stage). We determined nonfasting blood glucose, blood 1,5-anhydroglucitol, and messenger RNA levels of inflammatory cytokines in peripheral leukocytes in these rats. Nonfasting blood glucose concentrations gradually increased in OLETF rats fed the control diet, with significant increases at weeks 28 and 40 compared with week 0. In contrast, nonfasting blood glucose levels did not increase in Miglitol-treated rats during the experimental period. Miglitol-treated rats had lower nonfasting blood glucose levels and higher 1,5-anhydroglucitol levels, a marker for glucose fluctuations, at week 40 than control rats. The gene expression of inflammatory cytokines including interleukin-6, tumor necrosis factor-α, and interferon-γ in peripheral leukocytes gradually increased during the development of diabetes in control rats, but not in Miglitol-treated rats. Our results suggest that dietary supplementation with Miglitol from the preonset stage in OLETF rats improves glycemic control and reduces gene expression of cytokines related to inflammation in peripheral leukocytes.
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the α glucosidase inhibitor Miglitol decreases glucose fluctuations and inflammatory cytokine gene expression in peripheral leukocytes of japanese patients with type 2 diabetes mellitus
Metabolism-clinical and Experimental, 2010Co-Authors: Takeshi Osonoi, Kazuki Mochizuki, Nanae Fukaya, Masahiro Fuchigami, Miyoko Saito, Takeshi Muramatsu, Seiya Inoue, Toshinao GodaAbstract:In this study, we examined the effects of switching from acarbose or voglibose to Miglitol in type 2 diabetes mellitus patients for 3 months on gene expression of inflammatory cytokines/cytokine-like factors in peripheral leukocytes and on glucose fluctuations. We enrolled 47 Japanese patients with type 2 diabetes mellitus, aged 26 to 81 years, with hemoglobin A1c levels ranging from 6.5% to 7.9% and who were treated with the highest approved dose of acarbose (100 mg per meal) or voglibose (0.3 mg per meal) in combination with insulin or sulfonylurea. Their prior α-glucosidase inhibitors were switched to a medium dose of Miglitol (50 mg per meal), and the new treatments were maintained for 3 months. Forty-three patients completed the 3-month study and were analyzed. The switch to Miglitol for 3 months did not affect hemoglobin A1c, fasting glucose, triglycerides, total cholesterol, or C-reactive protein levels, or adverse events other than hypoglycemia symptoms. Hypoglycemia symptoms and glucose fluctuations were significantly improved by the switch. The expression of interleukin-1β, tumor necrosis factor-α, and S100a4/6/9/10/11/12 genes in peripheral leukocytes, and the serum tumor necrosis factor-α protein levels were suppressed by switching to Miglitol. Miglitol reduces glucose fluctuations and gene expression of inflammatory cytokines/cytokine-like factors in peripheral leukocytes of type 2 diabetes mellitus patients more than other α-glucosidase inhibitors and with fewer adverse effects.
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Changes in α-glucosidase activities along the jejunal-ileal axis of normal rats by the α-glucosidase inhibitor Miglitol.
Metabolism: clinical and experimental, 2010Co-Authors: Kazuki Mochizuki, Sachi Kuranuki, Kazuhito Suruga, Emiko Hanai, Toshinao GodaAbstract:Miglitol, an α-glucosidase inhibitor that inhibits postprandial hyperglycemia by delaying carbohydrate digestion and absorption along the jejunal-ileal axis, has recently been approved for use in patients with type 2 diabetes mellitus. Miglitol treatment may lead to increased α-glucosidase activities toward the ileum because carbohydrate flow toward the ileum increases. However, it is not yet known if Miglitol treatment alters the α-glucosidase activities along the jejunal-ileal axis. In this study, we examined the effects of Miglitol supplementation for 3 or 7 days on α-glucosidase activities along the jejunal-ileal axis of Wistar rats. Supplementation with Miglitol for 3 or 7 days in rats increased tissue weights of the lower jejunum and ileum, but did not alter tissue weights of the upper jejunum and cecum or the contents of the cecum. Furthermore, supplementation with Miglitol for 7 days reduced the activities of isomaltase and maltase in the upper jejunum and increased the activities of sucrase, isomaltase, and maltase in the lower jejunum and ileum. These results suggest that the delay in carbohydrate digestion and absorption along the jejunal-ileal axis by Miglitol supplementation in rats is associated with increased α-glucosidase activities toward the ileum.
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The α-glucosidase inhibitor Miglitol delays the development of diabetes and dysfunctional insulin secretion in pancreatic β-cells in OLETF rats
European Journal of Pharmacology, 2009Co-Authors: Nanae Fukaya, Kazuki Mochizuki, Toshihiko Kumazawa, Yutaro Tanaka, Zhu Jiuxin, Masahiro Fuchigami, Toshinao GodaAbstract:The Otsuka Long-Evans Tokushima Fatty (OLETF) rat, an animal model of type 2 diabetes, exhibits obesity, hyperglycemia and hyperlipidemia, with late onset of chronic and slowly progressive hyperinsulinemia. In this study, we examined effects of long-term dietary supplementation with the alpha-glucosidase inhibitor Miglitol on the development of diabetes and the reduction of beta-cells in the pancreas of OLETF rats. The OLETF rats were fed a control diet or a diet containing 800 ppm Miglitol (Miglitol diet) for 65 weeks from pre-onset stage (5 weeks old). The non-fasting blood glucose concentrations gradually increased in OLETF rats fed the control diet and, at week 64, were significantly higher than those in OLETF rats fed the Miglitol diet and age-matched Long-Evans Tokushima Otsuka (LETO) rats, which are control, non-diabetic, non-obese rats of the same strain. Oral glucose tolerance tests revealed that OLETF rats fed the control diet showed pronounced impaired glucose tolerance, but those fed the Miglitol diet did not. Furthermore, insulin concentrations after glucose-loading were significantly lower in OLETF rats fed the control diet than in those fed the Miglitol diet. The islets of 65-week-old OLETF rats fed the control diet showed significant fibrosis and loss of beta-cells, while those of age-matched control LETO rats had a normal appearance. Feeding OLETF rats a Miglitol diet reduced fibrosis and the loss of beta-cells. Our results suggest that dietary supplementation with Miglitol from pre-onset stage in OLETF rats delays the onset and development of diabetes and preserves the insulin secretory function of pancreatic islets.