Skip to main content
Top
Published in: Acta Diabetologica 1/2011

01-03-2011 | Original Article

Efficacy of combined use of miglitol in Type 2 diabetes patients receiving insulin therapy-placebo-controlled double-blind comparative study

Authors: Masami Nemoto, Naoko Tajima, Ryuzo Kawamori

Published in: Acta Diabetologica | Issue 1/2011

Login to get access

Abstract

Combination therapy with an α-glucosidase inhibitor and insulin is commonly performed for type 2 diabetes mellitus. We conducted a placebo-controlled double-blind comparative study to investigate the efficacy of combination therapy with miglitol and insulin. The patients with T2DM on insulin therapy were randomly assigned to either a miglitol treatment group (Group M) or a placebo group (Group P) and treated for 12 weeks. Meal tolerance tests were conducted at the observation period, week 0 and week 12 of the treatment period. Mean values of decrease in 1-h- and 2-h postprandial plasma glucose level were significantly larger in Group M than in Group P (60.3 ± 70.1 mg/dl vs. −5.1 ± 68.2 mg/dl (P < 0.001)), as was HbA1c as well (0.36 ± 0.66% vs. −0.03 ± 0.56% (P < 0.001)). Adverse events included abdominal distension and flatulence, which were significantly more frequent in Group M. The frequency of nocturnal hypoglycemia events tended to be reduced in Group M. Combined use of insulin and miglitol is useful for postprandial glucose regulation and improves glycemic control.
Literature
1.
go back to reference Moss SE, Klein R, Klein BE (1991) Cause-specific mortality in a population-based study of diabetes. Am J Public Health 81:1158–1162PubMedCrossRef Moss SE, Klein R, Klein BE (1991) Cause-specific mortality in a population-based study of diabetes. Am J Public Health 81:1158–1162PubMedCrossRef
2.
go back to reference Fox CS, Coady S, Sorlie PD, D’Agostino RB Sr, Pencina MJ, Vasan RS, Meigs JB, Levy D, Savage PJ (2007) Increasing cardiovascular disease burden due to diabetes mellitus: the Framingham Heart Study. Circulation 115:1544–1550PubMedCrossRef Fox CS, Coady S, Sorlie PD, D’Agostino RB Sr, Pencina MJ, Vasan RS, Meigs JB, Levy D, Savage PJ (2007) Increasing cardiovascular disease burden due to diabetes mellitus: the Framingham Heart Study. Circulation 115:1544–1550PubMedCrossRef
3.
go back to reference UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853CrossRef UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853CrossRef
4.
go back to reference Moss SE, Klein R, Klein BE, Meuer SM (1994) The association of glycemia and cause-specific mortality in a diabetic population. Arch Intern Med 154:2473–2479PubMedCrossRef Moss SE, Klein R, Klein BE, Meuer SM (1994) The association of glycemia and cause-specific mortality in a diabetic population. Arch Intern Med 154:2473–2479PubMedCrossRef
5.
go back to reference Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, Golden SH (2004) Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med 141:421–431PubMed Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, Golden SH (2004) Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med 141:421–431PubMed
6.
go back to reference Pantalone KM, Kattan MW, Yu C, Wells BJ, Arrigain S, Jain A, Atreja A, Zimmerman RS (2009) The risk of developing coronary artery disease or congestive heart failure, and overall mortality, in type 2 diabetic patients receiving rosiglitazone, pioglitazone, metformin, or sulfonylureas: a retrospective analysis. Acta Diabetol 46:145–154PubMedCrossRef Pantalone KM, Kattan MW, Yu C, Wells BJ, Arrigain S, Jain A, Atreja A, Zimmerman RS (2009) The risk of developing coronary artery disease or congestive heart failure, and overall mortality, in type 2 diabetic patients receiving rosiglitazone, pioglitazone, metformin, or sulfonylureas: a retrospective analysis. Acta Diabetol 46:145–154PubMedCrossRef
7.
go back to reference Bariş N, Erdoğan M, Sezer E, Saygili F, Mert Ozgönül A, Turgan N, Ersöz B (2009) Alterations in L-arginine and inflammatory markers in type 2 diabetic patients with and without microalbuminuria. Acta Diabetol 46:309–316PubMedCrossRef Bariş N, Erdoğan M, Sezer E, Saygili F, Mert Ozgönül A, Turgan N, Ersöz B (2009) Alterations in L-arginine and inflammatory markers in type 2 diabetic patients with and without microalbuminuria. Acta Diabetol 46:309–316PubMedCrossRef
8.
go back to reference Cerbone AM, Macarone-Palmieri N, Saldalamacchia G, Coppola A, Di Minno G, Rivellese AA (2009) Diabetes, vascular complications and antiplatelet therapy: open problems. Acta Diabetol 46:253–261PubMedCrossRef Cerbone AM, Macarone-Palmieri N, Saldalamacchia G, Coppola A, Di Minno G, Rivellese AA (2009) Diabetes, vascular complications and antiplatelet therapy: open problems. Acta Diabetol 46:253–261PubMedCrossRef
9.
10.
go back to reference Tarquini R, Lazzeri C, Pala L, Rotella CM, Gensini GF (2010) The diabetic cardiomyopathy. Acta Diabetol. (online) Tarquini R, Lazzeri C, Pala L, Rotella CM, Gensini GF (2010) The diabetic cardiomyopathy. Acta Diabetol. (online)
11.
go back to reference de Vegt F, Dekker JM, Ruhè HG, Stehouwer CDA, Nijpels GBLM, Heine RJ (1999) Hyperglycemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn Study. Diabetologia 42:926–931PubMedCrossRef de Vegt F, Dekker JM, Ruhè HG, Stehouwer CDA, Nijpels GBLM, Heine RJ (1999) Hyperglycemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn Study. Diabetologia 42:926–931PubMedCrossRef
12.
go back to reference Donahue RP, Abbott RD, Reed DM, Yano K (1997) Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry: Honolulu Heart Program. Diabetes 36:689–692CrossRef Donahue RP, Abbott RD, Reed DM, Yano K (1997) Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry: Honolulu Heart Program. Diabetes 36:689–692CrossRef
13.
go back to reference Lowe LP, Liu K, Greenland P, Metzger BE, Dyer AR, Stamler J (1997) Diabetes, asymptomatic hyperglycemia, and 22-year mortality in black and white men: the Chicago Heart Association Detection Project in Industry study. Diabetes Care 20:163–169PubMedCrossRef Lowe LP, Liu K, Greenland P, Metzger BE, Dyer AR, Stamler J (1997) Diabetes, asymptomatic hyperglycemia, and 22-year mortality in black and white men: the Chicago Heart Association Detection Project in Industry study. Diabetes Care 20:163–169PubMedCrossRef
14.
go back to reference Tominaga M, Eguchi H, Manaka H, Igarashi K, Kato T, Sekikawa A (1999) Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 22:920–924PubMedCrossRef Tominaga M, Eguchi H, Manaka H, Igarashi K, Kato T, Sekikawa A (1999) Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 22:920–924PubMedCrossRef
15.
go back to reference The DECODE Study Group, The European Diabetes Epidemiology Group (1999) Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. Lancet 354:617–621CrossRef The DECODE Study Group, The European Diabetes Epidemiology Group (1999) Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. Lancet 354:617–621CrossRef
16.
go back to reference Coutinho M, Gerstein HC, Wang Y, Yusuf S (1999) The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95, 783 individuals followed for 12.4 years. Diabetes Care 22:233–240PubMedCrossRef Coutinho M, Gerstein HC, Wang Y, Yusuf S (1999) The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95, 783 individuals followed for 12.4 years. Diabetes Care 22:233–240PubMedCrossRef
17.
go back to reference Balkau B, Shipley M, Jarrett RJ, Pyörälä K, Pyörälä M, Forhan A, Eschwège E (1998) High blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men: 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen Study. Diabetes Care 21:360–367PubMedCrossRef Balkau B, Shipley M, Jarrett RJ, Pyörälä K, Pyörälä M, Forhan A, Eschwège E (1998) High blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men: 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen Study. Diabetes Care 21:360–367PubMedCrossRef
18.
go back to reference The DECODE study group on behalf of the European Diabetes Epidemiology Group (2001) Glucose tolerance and cardiovascular mortality. Comparison of fasting and 2-h diagnostic criteria. Arch Intern Med 161:397–404CrossRef The DECODE study group on behalf of the European Diabetes Epidemiology Group (2001) Glucose tolerance and cardiovascular mortality. Comparison of fasting and 2-h diagnostic criteria. Arch Intern Med 161:397–404CrossRef
19.
go back to reference Giugliano D, Ceriello A, Paolisso G (1996) Oxidative stress and diabetic vascular complications. Diabetes Care 19:257–267PubMedCrossRef Giugliano D, Ceriello A, Paolisso G (1996) Oxidative stress and diabetic vascular complications. Diabetes Care 19:257–267PubMedCrossRef
20.
go back to reference Schmidt AM, Yan SD, Wautier JL, Stern D (1999) Activation of receptor for advanced glycation end products: a mechanism for chronic vascular dysfunction in diabetic vasculopathy and atherosclerosis. Circ Res 84:489–497PubMed Schmidt AM, Yan SD, Wautier JL, Stern D (1999) Activation of receptor for advanced glycation end products: a mechanism for chronic vascular dysfunction in diabetic vasculopathy and atherosclerosis. Circ Res 84:489–497PubMed
21.
go back to reference Diabetes mellitus-associated macrovascular disease (2007) Evidence-based guidelines for diabetes treatment, 2nd edn. Japan Diabetes Society, Tokyo, Nankodo, pp 113–150 Diabetes mellitus-associated macrovascular disease (2007) Evidence-based guidelines for diabetes treatment, 2nd edn. Japan Diabetes Society, Tokyo, Nankodo, pp 113–150
22.
go back to reference Anderson JH Jr, Brunelle RL, Keohane P, Koivisto VA, Trautmann ME, Vignati L et al (1997) Mealtime treatment with insulin analogue improves postprandial hyperglycemia and hypoglycemia in patients with non-insulin-dependent diabetes mellitus. Multicenter Insulin Lispro Study Group. Arch Intern Med 157:1249–1255PubMedCrossRef Anderson JH Jr, Brunelle RL, Keohane P, Koivisto VA, Trautmann ME, Vignati L et al (1997) Mealtime treatment with insulin analogue improves postprandial hyperglycemia and hypoglycemia in patients with non-insulin-dependent diabetes mellitus. Multicenter Insulin Lispro Study Group. Arch Intern Med 157:1249–1255PubMedCrossRef
23.
go back to reference Tajima N, Abe J, Kawamori R (2006) Clinical effects of sulfonylurea agents in type 2 diabetes mellitus patients in treatment. Pharmacol Ther 34:79–90 Tajima N, Abe J, Kawamori R (2006) Clinical effects of sulfonylurea agents in type 2 diabetes mellitus patients in treatment. Pharmacol Ther 34:79–90
24.
go back to reference The Diabetes Control Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986CrossRef The Diabetes Control Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986CrossRef
25.
go back to reference Janka HU, Plewe G, Riddle MC, Kliebe-Frisch C, Schweitzer MA, Yki-Järvinen H (2005) Comparison of basal insulin added to oral agents versus twice-daily premixed insulin as initial insulin therapy for type 2 diabetes. Diabetes Care 28:254–259PubMedCrossRef Janka HU, Plewe G, Riddle MC, Kliebe-Frisch C, Schweitzer MA, Yki-Järvinen H (2005) Comparison of basal insulin added to oral agents versus twice-daily premixed insulin as initial insulin therapy for type 2 diabetes. Diabetes Care 28:254–259PubMedCrossRef
26.
go back to reference Hotta N, Kakuta H, Koh N, Sakakibara F, Haga T, Sano T et al (1993) The effect of acarbose on blood glucose profiles of type 2 diabetic patients receiving insulin therapy. Diabet Med 10:355–358PubMedCrossRef Hotta N, Kakuta H, Koh N, Sakakibara F, Haga T, Sano T et al (1993) The effect of acarbose on blood glucose profiles of type 2 diabetic patients receiving insulin therapy. Diabet Med 10:355–358PubMedCrossRef
27.
go back to reference McCulloch DK, Kurtz AB, Tattersall RB (1983) A new approach to the treatment of nocturnal hypoglycemia using alpha-glucosidase inhibition. Diabetes Care 6:483–487PubMedCrossRef McCulloch DK, Kurtz AB, Tattersall RB (1983) A new approach to the treatment of nocturnal hypoglycemia using alpha-glucosidase inhibition. Diabetes Care 6:483–487PubMedCrossRef
28.
go back to reference Kanda T, Konno E (2001) Alpha-glucosidase inhibitors and insulin injection therapy. Endocrinol Diabetol 12:579–587 Kanda T, Konno E (2001) Alpha-glucosidase inhibitors and insulin injection therapy. Endocrinol Diabetol 12:579–587
29.
go back to reference Osonoi T (2008) Characteristics of various α-GIs and points to remember in their use. Endocrinol Diabetol 26:72–80 Osonoi T (2008) Characteristics of various α-GIs and points to remember in their use. Endocrinol Diabetol 26:72–80
30.
go back to reference Ishii H, Furuya M, Ishibashi R, Tsujii S (2005) Preparation of a new questionnaire on blood glucose control and attempt to understand hypoglycemia and hyperglycemia in insulin therapy patients. Diabetes 48:19–32 Ishii H, Furuya M, Ishibashi R, Tsujii S (2005) Preparation of a new questionnaire on blood glucose control and attempt to understand hypoglycemia and hyperglycemia in insulin therapy patients. Diabetes 48:19–32
Metadata
Title
Efficacy of combined use of miglitol in Type 2 diabetes patients receiving insulin therapy-placebo-controlled double-blind comparative study
Authors
Masami Nemoto
Naoko Tajima
Ryuzo Kawamori
Publication date
01-03-2011
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 1/2011
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-010-0206-4

Other articles of this Issue 1/2011

Acta Diabetologica 1/2011 Go to the issue

Review Article

The IGF system

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine