Relationship Between Gastric Emptying and an α-Glucosidase Inhibitor Effect on Postprandial Hyperglycemia in NIDDM Patients

Takahiko Kawagishi; Yoshiki Nishizawa; Hiromichi Taniwaki; Shinji Tanaka; Yasuhisa Okuno; Masaaki Inaba; Eiji Ishimura; Masanori Emoto; Hirotoshi Morii

doi:10.2337/diacare.20.10.1529

Original Articles

Relationship Between Gastric Emptying and an α-Glucosidase Inhibitor Effect on Postprandial Hyperglycemia in NIDDM Patients

Takahiko Kawagishi, MD,
Yoshiki Nishizawa, MD,
Hiromichi Taniwaki, MD,
Shinji Tanaka, MD,
Yasuhisa Okuno, MD,
Masaaki Inaba, MD,
Eiji Ishimura, MD,
Masanori Emoto, MD and
Hirotoshi Morii, MD

Second Department of Internal Medicine, Osaka City University Medical School Osaka, Japan

Address correspondence and reprint requests to Takahiko Kawagishi, MD, Second Department of Internal Medicine, Osaka City University Medical School, 1–5–7, Asahi-machi, Abeno-ku, Osaka, 545 Japan.

Diabetes Care 1997 Oct; 20(10): 1529-1532. https://doi.org/10.2337/diacare.20.10.1529

Abstract

OBJECTIVE The purpose of the study was to examine the relationship between gastric emptying and the efficacy of an α-glucosidase inhibitor in NIDDM patients.

RESEARCH DESIGN AND METHODS Sixteen NIDDM patients (4 patients treated with diet therapy alone and 12 receiving a sulfonylurea) were given 0.6 mg of voglibose daily for 4 weeks. The efficacy of voglibose was assessed by measurement of HbA_1c, fasting plasma glucose, and 45- and 120-min postprandial plasma glucose (PPG) and serum insulin concentrations before and after the 4 weeks of voglibose therapy. Gastric emptying was evaluated using the proportional cumulative area under the absorption curve (% AUC) of plasma acetaminophen concentration at 60 min after ingestion of a liquid test meal containing 20 mg/kg of acetaminophen. These measurements were also taken before and after the therapy.

RESULTS The change in the 45-min PPG levels from the fasting state correlated significantly with the % AUC of the plasma acetaminophen concentrations (r = 0.625, P = 0.0096) before the voglibose administrations. The mean 45-min and 2-h PPG levels were reduced significantly after 4 weeks of voglibose (P < 0.05 and P < 0.01, respectively). Two-hour postprandial serum insulin concentrations were also significantly reduced at the end of the treatment period (P < 0.05). The changes in the PPG levels between pre- and posttreatment periods correlated significantly with the % AUC of the plasma acetaminophen concentrations before the treatment period (r = 0.499, P = 0.0490; r = 0.713, P = 0.0019, respectively). There was no significant difference in the plasma acetaminophen concentrations between pre- and posttreatment periods.

CONCLUSIONS The rate of gastric emptying affects the efficacy of voglibose therapy in NIDDM patients. Voglibose did not however alter the rate of gastric emptying.