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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The present study aimed at investigating the metabolic effects and tolerance of two desoxynojirimycin derivatives with alpha-glucosidase inhibitory properties (BAY m 1099 and BAY o 1248). The study was performed in a double-blind cross-over manner on 7 insulin-treated outpatient diabetics (6 males, 1 female; mean age 43 +/- 14 years; mean duration of diabetes 5.8 +/- 4.2 years; all within +/- 10% of their ideal body weight). The usual diet containing 24.5 +/- 8 g dietary fibers and 52 +/- 22 g simple sugars was maintained throughout the study. After a 7-day run-in period, 4 consecutive periods of 7 days were considered for each patient. The patients were randomly allocated for 1 week to BAY o 1248 (20 mg with breakfast) or Bay m 1099 (50 mg with breakfast and dinner). After a 7-day wash-out period the patients underwent the alternate treatment. At the end of each period, the patients were admitted to the Metabolic Ward for detailed metabolic and hormonal investigations. No significant changes were observed in the daily insulin requirements (45 +/- 15 U/day). HbA1c did not change significantly. Residual insulin secretion was low (plasma C-peptide: 0.077 +/- 0.09 and 0.154 +/- 0.15 pmol/ml during fasting and 2 hours post-breakfast, respectively); it was not modified by the treatments. Increments in blood glucose were significantly lower after breakfast with both drugs. No differences were observed in plasma free insulin. A marked increase in breath hydrogen was observed after lunch with BAY o 1248 only. Clinical and biological tolerance was excellent for both compounds.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Assessment of the clinical efficacy and tolerance of two new alpha-glucosidase inhibitors in insulin-treated diabetics. 331 59

1. alpha-Glucosidase inhibitors delay carbohydrate absorption and have been proposed as adjunctive therapy for diabetes mellitus. 2. To determine the effects of two new alpha-glucosidase inhibitors, Bay-m-1099 and Bay-o-1248, on meal carbohydrate and lipid tolerance, plasma glucose, insulin and triglyceride levels were measured at 15-60 min intervals over 12 h after ingestion of a standard breakfast, lunch and dinner of identical composition in 31 normal volunteers. 3. The volunteers were randomized to receive either Bay-m-1099 (50 or 25 mg) or placebo prior to each meal, or the single administration of Bay-o-1248 (20 or 10 mg) or placebo prior to breakfast. 4. Only Bay-m-1099 at the 50 mg dose reduced significantly the postprandial increase in plasma insulin levels after each meal when compared with placebo (25, 36, 54% at breakfast, lunch, and dinner, respectively; P less than 0.05). Both drugs were well tolerated, with side effects limited to complaints of flatulence. 5. Thus, with the dosage schedule employed, Bay-m-1099, but not Bay-o-1248, significantly reduced postprandial increments in plasma insulin.
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PMID:The effect of two new alpha-glucosidase inhibitors on metabolic responses to a mixed meal in normal volunteers. 332 89

To examine prolonged alpha-glucosidase inhibition on blood glucose control, Acarbose, a potent alpha-glucosidase inhibitor, was administered for six months to insulin-dependent diabetic patients. Acarbose administration significantly diminished postprandial blood glucose increases by 20-30% and reduced insulin requirements by about 40% in these patients. Symptoms related to its use almost disappeared after the first month of treatment. These results suggest that prolonged alpha-glucosidase inhibition improves glucose tolerance in patients with insulin-dependent diabetes mellitus. Thus, an agent like acarbose might be a useful adjunct to insulin in the treatment of diabetic patients.
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PMID:Effects of prolonged (6 months) alpha-glucosidase inhibition on blood glucose control and insulin requirements in patients with insulin-dependent diabetes mellitus. 351 13

BAYo1248 and BAYm1099 are two new alpha-glucosidase inhibitors. Postprandial glucose tolerance was significantly improved and postprandial insulin requirements were significantly reduced as compared to placebo after breakfast and lunch when 20 mg BAYo1248 were administered prior to breakfast and after breakfast, lunch and dinner when 50 mg BAYm1099 were given prior to all three main meals. Postprandial breath H2 concentrations were mildly increased when these alpha-glucosidase inhibitors were given and no patient complained of any adverse effects (such as flatulence, abdominal pain or diarrhea). BAYo1248 and BAYm1099 might be useful adjuncts to insulin in the treatment of patients with insulin-dependent diabetes mellitus.
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PMID:Effects of two new alpha-glucosidase inhibitors on glycemic control in patients with insulin-dependent diabetes mellitus. 352 Jan 33

We investigated the hormonal and metabolic response to a 100-g sucrose load given 15 min after adaptation to moderate-intensity (50% VmaxO2) long-duration (4-h) exercise in healthy volunteers. The effect of a 100-mg dose of the alpha-glucosidase inhibitor Acarbose ingested with the sucrose load was also investigated. "Naturally labeled [13C] sucrose" was used to follow the conversion to expired-air CO2 of the sugar ingested by isotope-ratio mass spectrometry. Circulating hormone and metabolite data were obtained in nine subjects, and indirect calorimetry and stable isotope methodology were applied to six of them. Under placebo, 93 +/- 4 g sucrose were entirely oxidized during the 4 h of exercise, total carbohydrate utilization was 235 +/- 14 g, endogenous carbohydrate utilization was 142 +/- 13 g, and total lipid oxidation was 121 +/- 7 g. A single oral dose of 100 mg Acarbose ingested with the sucrose load did not significantly modify total carbohydrate (239 +/- 2 g/4 h) or lipid (122 +/- 6 g/4 h) oxidation. In contrast, sucrose oxidation was reduced to 53 +/- 6 g/4 h and endogenous carbohydrate utilization increased to 186 +/- 7 g/4 h. Reduction of the rises in blood glucose and fructose and of the increases in plasma insulin and C peptide under Acarbose confirmed these effects, whereas lower circulating levels of alanine suggested a higher rate of gluconeogenesis. These data show that a 100-g glucose load ingested soon after initiation of exercise is a perfect available metabolic substrate.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes 1986 Nov
PMID:Utilization of oral sucrose load during exercise in humans. Effect of the alpha-glucosidase inhibitor acarbose. 353 Aug 58

The alpha-glucosidase inhibitor BAY m 1099, a deoxynojirimycin derivative, was studied in sulfonylurea-treated type II diabetic patients using a placebo-controlled double-blind cross-over design. Given in two daily doses the inhibitor smoothened the blood glucose profile by lowering significantly post-prandial blood glucose peaks. Fasting and daily mean blood glucose levels measured as the area under the blood glucose curves were however not influenced significantly. This might be due to the short duration of the treatment periods or the low dosage of the drug. Abdominal side effects were negligible. The alpha-glucosidase inhibitor BAY m 1099 might become a useful therapeutic tool in addition to sulfonylurea treatment in type II diabetes.
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PMID:Smoothing effect of a new alpha-glucosidase inhibitor BAY m 1099 on blood glucose profiles of sulfonylurea-treated type II diabetic patients. 353 37

Miglitol is an alpha-glucosidase inhibitor which lowers blood glucose and insulin concentrations in healthy volunteers after a starch meal. It also lowers blood glucose concentrations after a starch meal in patients with non-insulin-dependent diabetes mellitus, but under these circumstances insulin is unaffected. We have studied the effect of miglitol after a glucose load in six healthy male volunteers. Although one would expect an alpha-glucosidase inhibitor to have no effect on blood glucose concentrations after a glucose load, miglitol produced a significant decrease in blood glucose concentrations after the absorption peak. This could be due to enhancement of insulin effects or to depression of anti-insulin factors.
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PMID:Miglitol may have a blood glucose lowering effect unrelated to inhibition of alpha-glucosidase. 354 25

With use of the alpha-glucosidase inhibitor bay g 5421 (acarbose), it is possible to improve glycemic profiles in diabetics without a concomitant increase in insulin levels or weight reduction. We have taken advantage of this feature to test whether an improvement in glycemic control alone can ameliorate some of the known abnormalities of type II diabetes (ie, impaired insulin secretion, elevated rate of basal hepatic glucose output, peripheral insulin resistance). We have studied eight type II diabetics (mean +/- SE fasting serum glucose 193 +/- 25 mg/dL) before and after 2 weeks of acarbose therapy (100 mg with each meal). Assessment of endogenous insulin secretion, peripheral and hepatic insulin sensitivity, and adipose tissue lipoprotein lipase (ATLPL) activity were performed. Results showed significant lowering of postprandial glucose excursions above basal but no change in basal serum glucose levels, marked reduction in fasting and day-long triglyceride levels and in spite of a reduction in ATLPL activity, an increase in hepatic sensitivity to insulin's ability to suppress hepatic glucose output, and no effect on peripheral insulin sensitivity. In conclusion, inhibition of carbohydrate digestion with alpha-glucosidase inhibitors ameliorates many of the metabolic abnormalities in type II (noninsulin-dependent diabetics), suggesting that agents of this type can be of therapeutic value.
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PMID:The effect of short-term alpha-glucosidase inhibition on carbohydrate and lipid metabolism in type II (noninsulin-dependent) diabetics. 355 48

In patients with diabetes mellitus, delayed increases in circulating insulin levels followed by prolonged hyperinsulinemia due to slow absorption of subcutaneously administered insulin hinders maintenance of euglycemia. To determine whether a delay in carbohydrate absorption would increase the effectiveness of subcutaneous insulin in controlling postprandial hyperglycemia in patients with insulin-dependent diabetes mellitus and whether it could allow insulin to be taken immediately prior to meals, the effects of an alpha-glucosidase inhibitor (Acarbose Boyer AG, Wuppertal, Germany) on postprandial plasma glucose profiles were determined in six subjects with insulin-dependent diabetes when a subcutaneous insulin infusion was started immediately or 30 minutes prior to meal ingestion. When 25% less insulin (9 v 12 units) was given along with Acarbose 30 minutes prior to meal ingestion, postprandial hyperglycemia decreased by 45% (areas under the curve, AUC, 8193 +/- 1960 v 14783 +/- 2260 mg/dL X min, P less than 0.02). When similar amounts of insulin (12 units) were given immediately prior to meal ingestion, postprandial hyperglycemia decreased 55% (AUC 6187 +/- 2240 v 13642 +/- 1579 mg/dL X min, P less than 0.001). These results indicate that delay in carbohydrate absorption improves the effectiveness of subcutaneous insulin in controlling postprandial hyperglycemia in patients with insulin-dependent diabetes mellitus and may permit satisfactory postprandial glycemic control when insulin is administered immediately prior to meal ingestion. Thus, an agent like Acarbose, which delays carbohydrate absorption, may be useful as an adjunct to insulin in the treatment of diabetes mellitus.
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PMID:alpha-Glucosidase inhibition improves postprandial hyperglycemia and decreases insulin requirements in insulin-dependent diabetes mellitus. 388 97

The lysosomal enzymes cathepsin D (E.C. 3.4.23.5), alpha-glucosidase (E.C. 3.2.1.20) and beta-galactosidase (E.C. 3.2.1.23), potentially involved in the breakdown of the peptide component and the disaccharide units of basement membrane glycoproteins, were studied in the kidney cortex and liver of streptozotocin-diabetic mice. In the liver of diabetic mice, as compared to controls, an increase was found for the total activity (measured in frozen-thawed homogenates) of cathepsin D (+135%, P less than 0.01) and beta-galactosidase (+32%, P less than 0.05). In the kidney a decrease was observed for both the free activity (measured in 12,000 g supernatant) and the total activity of these two enzymes (cathepsin D: -62% and -24%; beta-galactosidase: -29% and -23%; P less than 0.05 in all instances). Alpha-glucosidase did not show significant changes in either tissues. Total protein content of the two organs did not change significantly with diabetes and therefore cannot account for the enzyme alterations observed. These data indicate that the response of kidney to diabetes is opposite to that of liver (decrease versus increase in catabolic enzymes), and suggest decreased degradation of basement membrane in some tissues in diabetes, which may contribute to the thickening of basement membrane and therefore to the development of microangiopathy.
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PMID:Cathepsin D and other hydrolases in the kidney of streptozotocin-diabetic mice. Possible relevance to microangiopathy. 393 Mar 80


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