Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.2.1.20 (alpha-glucosidase)
 4,237 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article reviewed the relevant literature including published clinical trials and reviews on currently available oral hypoglycemic agents. Results showed that the benefits of glycemic control have been established through multiple clinical trials. Long-term control of blood glucose levels in type 1 and type 2 diabetic patients will decrease the incidence and prolong the time until progression of diabetic retinopathy, nephropathy, and neuropathy. Our increased understanding of the pathophysiology behind type 2 diabetes has led to the development of many new agents that are aimed at treating the underlying insulin resistance and relative insulinopenia. The sulfonylureas as a group have been used for many years and act by stimulating insulin secretion. They are useful alone or as combination therapy with insulin or another oral hypoglycemic agent. The biguanides act by decreasing hepatic glucose production and by increasing peripheral insulin sensitivity. The alpha-glucosidase inhibitors act nonsystemically by blocking the metabolism of digested polysaccharides and therefore lowering the amount of carbohydrate absorbed in a meal. Benzoic acid derivatives act in a manner similar to that of sulfonylureas by enhancing pancreatic insulin production. They offer a shorter duration of action, lowering the risk of hypoglycemia. The thiazolidinediones increase peripheral insulin sensitivity and are effective as both monotherapy and combination therapy. Oral hypoglycemic agents, when properly administered, are very effective in controlling type 2 diabetes and preventing long-term complications.
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PMID:New directions in type 2 diabetes mellitus: an update of current oral antidiabetic therapy. 1064 11

Currently available oral agents for the treatment of type 2 diabetes mellitus include a variety of compounds from 5 different pharmacologic classes with differing mechanisms of action, adverse effect profiles, and toxicities. The oral antidiabetic drugs can be classified as either hypoglycemic agents (sulfonylureas and benzoic acid derivatives) or antihyperglycemic agents (biguanides, alpha-glucosidase inhibitors, and thiazolidinediones). In this review, a brief discussion of the pharmacology of these agents is followed by an examination of the adverse effects, drug-drug interactions, and toxicities. Finally, treatment of sulfonylurea-induced hypoglycemia is described, including general supportive care and the management of pediatric sulfonylurea ingestions. The adjunctive roles of glucagon, diazoxide, and octreotide for refractory hypoglycemia are also discussed.
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PMID:Oral agents for the treatment of type 2 diabetes mellitus: pharmacology, toxicity, and treatment. 1142 16

Pharmacological therapy for Type 2 (non-insulin-dependent) diabetes mellitus aims at controlling hyperglycaemia to delay or prevent complications associated with the disease. Most patients with Type 2 diabetes present with both stimulated insulin deficiency and insulin resistance. In general, the former can manifest as postprandial hyperglycaemia and the latter as fasting hyperglycaemia, though a definitive association has not been established. Emerging data show a high failure rate of long-term monotherapy and establishes the significance of mealtime glycaemia and the role of postprandial glucose excursions in the development and progression of vascular complications. To overcome such failures of monotherapy and to address the different underlying defects of the pathology of Type 2 diabetes, a combined therapy of oral antidiabetic agents with complementary modes of action should be considered. Currently used oral antidiabetic agents such as sulphonylureas, biguanides (metformin) and the thiazolidinediones (rosiglitazone, pioglitazone) commonly target fasting hyperglycaemia and have limited additive effects on postprandial glycaemia. In contrast, alpha-glucosidase inhibitors can reduce postprandial hyperglycaemia but gastrointestinal side effects restrict their use. The development of new agents to control postprandial glucose excursions could be considered as an additional objective for the management of Type 2 diabetes. To this end new short-acting enhancers of insulin secretion such as repaglinide (benzoic acid derivative) and nateglinide (amino acid derivative) have been developed. The combination of such agents with other complementary modes of action, e.g. an insulin sensitizer, could target better major underlying defects of Type 2 diabetes and thereby provide a better approach for controlling the entire glycaemic risk.
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PMID:Rationale and options for combination therapy in the treatment of Type 2 diabetes. 1265 58

The present study attempted to evaluate the mechanism of action and bioactivity of mulberry leaf polyphenols (MLPs) in type-2 diabetes prevention via inhibition of disaccharidase and glucose transport. MLPs were purified with D101 resin and the main composition was determined as chlorogenic acid, rutin, benzoic acid and hyperoside. MLPs demonstrated a strong inhibitory effect on disaccharidases derived from both mouse and Caco-2 cells, and the order of IC50 value was: murine sucrase (7.065 mg mL-1) > murine maltase (4.037 mg mL-1) > Caco-2 cell maltase (0.732 mg mL-1) > Caco-2 cell sucrase (0.146 mg mL-1). MLPs showed the strongest inhibitory effect on sucrase derived from Caco-2 cells and played a role in lowering postprandial glucose mainly by inhibiting sucrase activity. The Caco-2 monolayer cell model was established to simulate the glucose transport process in the human small intestine. We found that within the concentration range of 0.5-2 mg mL-1, MLPs significantly inhibited glucose transport, and the inhibition rate increased with time and dose. The effect of phlorizin (SGLT1 inhibitor) in the control group showed a similar effect on glucose transport, revealing that MLPs may inhibit glucose transport mainly by inhibiting the SGLT1 transporter. RT-qPCR analysis confirmed that MLPs inhibited glucose absorption by suppressing the SGLT1-GLUT2 pathway via downregulation of the mRNA expression of phospholipase, protein kinase A and protein kinase C.
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PMID:Mulberry leaf polyphenols attenuated postprandial glucose absorption via inhibition of disaccharidases activity and glucose transport in Caco-2 cells. 3206 88