An Importance of Carbohydrate Ingestion for the Expression of the Effect of α-Glucosidase Inhibitor in NIDDM

Tomohiro Hara; Jiro Nakamura; Naoki Koh; Fumihiko Sakakibara; Naohide Takeuchi; Nigishi Hotta

doi:10.2337/diacare.19.6.642

Original Articles

An Importance of Carbohydrate Ingestion for the Expression of the Effect of α-Glucosidase Inhibitor in NIDDM

Tomohiro Hara, MD,
Jiro Nakamura, MD,
Naoki Koh, MD,
Fumihiko Sakakibara, MD,
Naohide Takeuchi, MD and
Nigishi Hotta, MD

Third Department of Internal Medicine, Nagoya University School of Medicine Nagoya, Japan

Address correspondence and reprint requests to Nigishi Hotta, MD, The Third Department of Internal Medicine, Nagoya University School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466, Japan

Diabetes Care 1996 Jun; 19(6): 642-647. https://doi.org/10.2337/diacare.19.6.642

Abstract

OBJECTIVE To examine the usefulness of α-glucosidase inhibitors in glycemic control of patients with NIDDM. The involvement of carbohydrate ingestion in manifestation of the effects of α-glucosidase inhibitors was also investigated.

RESEARCH DESIGN AND METHODS A total of 41 patients hospitalized with NIDDM (22 patients receiving sulfonylurea and 19 receiving insulin therapy) were given α-glucosidase inhibitors during the period when their blood glucose levels were well controlled. They were followed for 3 weeks as inpatients and for an additional 6 months as outpatients. They were retrospectively divided into two groups according to the percentage of carbohydrates in all sources of calories during outpatient management: the <50% group and the >50% group. Between these two groups, we compared circadian variation in blood glucose levels, HbA_1c, and urine C-peptide.

RESULTS Treatment with alpha-glucosidase inhibitors during the hospital stay markedly improved circadian variation in blood glucose levels and HbA_1c and decreased urine C-peptide in both groups. While HbA_1c returned to its pretreatment level at 6 months after the treatment in the <50% group, HbA_1c had further improved in the >50% group at 6 months.

CONCLUSIONS α-Glucosidase inhibitors are useful for glycemic control in patients with NIDDM and the percentage of carbohydrate in all calorie sources is an important factor for the expression of their effects.