Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acarbose, an alpha-glucosidase inhibitor, lowers the glycemic excursion following the ingestion of carbohydrates, in particular, sucrose. This was confirmed with increasing doses of acarbose (0, 50, and 100 mg) and the causes investigated. The absorption of the glucose moiety of sucrose was determined from plasma tracer concentrations when overnight-fasted normal subjects received a 100-g oral sucrose load labeled with sucrose [(1-14C]glucose and a simultaneous intravenous infusion of [3-3H]glucose. As the dose of acarbose given with the sucrose load was increased from 0 to 100 mg, the percentage of the load appearing in the peripheral circulation decreased from 90% to 62%. Malabsorption was confirmed by the appearance of breath hydrogen. Simultaneously, absorption time increased from 243 to 411 min. Maximal glycemic excursions were therefore lowered from 64 to 31 mg/dl. The plasma concentrations of gastric inhibitory polypeptide and insulin decreased with the acarbose dose so that the fractional disappearance rate of glucose also decreased. However, the concentrations of glucagon-like immunoreactivity (GLI) rose, confirming the ileal appearance of malabsorbed sucrose.
Diabetes 1984 Mar
PMID:The effects of an alpha-glucoside hydrolase inhibitor on glycemia and the absorption of sucrose in man determined using a tracer method. 636 57

The catalytic activities of N-acetyl-beta-D-glucosaminidase, beta-galactosidase and alpha-glucosidase in kidney and urine of diabetic rats were investigated in relation to the duration of diabetes, to the degree of constant hyperglycaemia and to the therapeutic control in the early stage of disease. The results suggest that the degree of constant hyperglycaemia and the duration of untreated diabetes are significant determining factors for the course of morphological changes. These changes are manifested as a decrease of the glycosidases in kidney (0.5 to 0.6 time the age-matched controls) and as moderate to severe enzymurias. Daily variation of blood glucose with inadequate insulin Lente therapy caused decreased N-acetyl-beta-D-glucosaminidase and beta-galactosidase activities in kidney as well as enzymuria. Since such changes can be correlated with histologically visible changes in the kidney, the measurement of these enzymes in urine is a simple way of monitoring the development of kidney damage in poorly controlled diabetes. When constant normoglycaemia was maintained for three weeks with insulin Ultralente in diabetic rats with a confirmed decrease of kidney glycosidases, the persisting morphological alteration of the organ was reflected by a urinary output of N-acetyl-beta-D-glucosaminidase.
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PMID:Effect of the degree of hyperglycaemia on the catalytic activities of glycosidases in kidney and urine of diabetic rats. 636 9

The postprandial blood glucose rise after a standard meal in six non-insulin dependent diabetics was significantly lower when acarbose 200 mg was taken together with the meal than without acarbose. Eight weeks acarbose treatment (300 mg), however, did not change fasting blood glucose. The effect of four weeks administration of the alpha-glucosidase inhibitor acarbose (300 mg) on diabetes regulation in another ten non-insulin dependent diabetics was compared with metformin (500 mg) in a double-blind cross-over study. Acarbose lowered postprandial blood glucose level from 11.5 +/- 4.2 to 8.9 +/- 1.8 mmol/l (p less than 0.02) and haemoglobin Alc from 8.1 +/- 1.8 to 7.7 +/- 1.7% (p less than 0.05). Urinary glucose was also decreased. Metformin did not significantly change postprandial blood glucose, haemoglobin A1c and urinary glucose excretion with the prescribed dose. The postprandial blood glucose and haemoglobin A1c after 4 weeks of treatment with acarbose and of metformin did not differ significantly. Side-effects of both drugs were mild and mainly gastrointestinal, but the frequency of side-effects was not different.
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PMID:Acarbose treatment of sulfonylurea-treated non-insulin dependent diabetics. A double-blind cross-over comparison of an alpha-glucosidase inhibitor with metformin. 639 73

Nocturnal hypoglycemia is common in the diabetic patient on twice-daily regular and intermediate (NPH or lente) insulin regimens because intermediate-acting insulins before the main evening meal produce "unopposed" free insulin peaks around 0300 h, food absorption having been completed much earlier. Fourteen insulin-dependent diabetic patients were treated for 6 wk with the alpha-glucosidase inhibitor, acarbose, in a double-blind crossover study to see whether the drug would delay absorption of the evening meal sufficiently to correct the mismatch and prevent nocturnal hypoglycemia. On 200 mg acarbose (six patients), inhibition of carbohydrate digestion was so profound as to lead to midevening hypoglycemia with severe flatulence and abdominal colic. With a smaller dose of 100 mg before the evening meal (eight patients) there was a significant reduction in MAGE and MBG coupled with a clinically significant reduction in midevening and nocturnal hypoglycemic reactions. Alpha-glucosidase inhibition therefore provides a promising new approach to the problem of nocturnal hypoglycemia although a preparation that is safe for long-term clinical use remains to be found.
Diabetes Care
PMID:A new approach to the treatment of nocturnal hypoglycemia using alpha-glucosidase inhibition. 640 Jul 9

Specific and total activities of the disaccharidases, sucrase, maltase, and lactase are increased in mucosa of the small intestine of the streptozotocin diabetic rat. Because disaccharidases are essential for terminal digestion of carbohydrate, and disaccharidase deficiency is a common clinical problem, understanding the mechanisms regulating disaccharidase activity is important. In normal animals, disaccharidase activities are determined by route of feeding and are decreased by parenteral feeding. The indirect exocrine, endocrine, neurocrine, and paracrine functions of the gastrointestinal tract that are dependent on feeding via the gut are greatly decreased in parenteral as compared with enteral feeding. Hormone secretion by the gut and the pattern of response after feeding may be abnormal in diabetes and might be regulatory for disaccharidases. We tested the hypothesis that the elevated intestinal disaccharidases in diabetes are dependent on enteral feeding. Streptozotocin-injected rats (diabetics) and vehicle-injected rats (controls) were fed rat chow ad libitum for 4 days. A subset of control and diabetic animals was then killed to determine disaccharidase activity of the jejunum at the start of pair-feeding the elemental diet. The remaining animals were fed 60 cal/day of glucose, amino acid (Travasol), and electrolyte solution either intragastrically or intravenously for 4 days. Specific and total activities of disaccharidases were greater in diabetics than in controls under all feeding conditions. In controls, the pattern of activity of disaccharidase specific activity was initial greater than intragastric greater than intravenous. In diabetics, disaccharidase specific activities did not differ among groups. In both controls and diabetics, mean mucosal mass was highest initially; intermediate with intragastric feeding; and lowest with intravenous feeding. In both controls and diabetics, total disaccharidases decreased from initial to intragastric to intravenous. We conclude: (1) disaccharidase specific activity in controls is sensitive to feeding route and nature of diet, but is nearly independent of these factors in diabetics; (2) total disaccharidase activities respond to feeding stimuli in parallel with changes in mucosal mass in both controls and diabetics; and (3) the lack of feeding effect on the elevated specific activities of disaccharidases in diabetes suggests that this elevation is a response to the diabetic state and is independent of enteral factors such as luminal nutrition and gastrointestinal hormones.
Diabetes 1983 Mar
PMID:Elevated intestinal disaccharidase activity in the streptozotocin-diabetic rat is independent of enteral feeding. 640 7

The binding of the lectins concanavalin A (Con A) and wheat germ agglutinin (WGA) to the luminal surface of lung alveolar epithelial cells was compared in normal rats and rats with streptozotocin-induced diabetes and their offspring. Lung tissue was lavaged, then fixed in situ with 3% glutaraldehyde. Buffer-rinsed slices of lung were incubated in Con A, WGA, or various control media. Lectin binding sites were visualized by the use of the peroxidase method. Normal neonates and those that were the results of diabetic pregnancies showed a hexose-specific Con A and WGA binding pattern qualitatively similar to that of normal and diabetic adults, respectively. In the normal animals, Con A binding sites were masked by sialic acid residues and were removable with alpha-mannosidase after neuraminidase treatment. In the diabetic adults and their offspring, one the other hand, Con A binding sites were readily accessible and were totally removed only by sequential treatment with alpha-mannosidase and alpha-glucosidase. WGA binding was essentially eliminated with neuraminidase in all animals except in the neonates from diabetic pregnancies, where N-acetyl-glucosaminidase was also required. The effects of maternal diabetes were reversible and occurred about Day 7 postpartum in the neonate. The effects were also reversible following insulin replacement in the diabetic adult.
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PMID:Diabetic pregnancy. Changes in lectin binding to the surface of rat lung alveolar epithelial cells. 668 9

Acarbose is a newly developed inhibitor of intestinal alpha-glucosidase, and in the current study its ability to lower plasma glucose levels was studied in 12 patients with non-insulin-dependent diabetes mellitus, poorly controlled on diet plus sulfonylurea drugs. Patients were studied before and three months after the addition of acarbose to their treatment program, and there was a notable fall in postprandial plasma glucose concentrations that approximated 60 mg/dL. When acarbose therapy was discontinued in five patients, plasma glucose levels rapidly returned toward pretreatment levels. In addition to the improvement in glycemia, acarbose treatment also led to a notable reduction in Hb A1c and triglyceride concentrations. Finally, considerable individual variation was noted in the response to acarbose, and the results in four patients were quite dramatic, with striking reductions in both fasting and postprandial glucose concentrations. These data suggest that acarbose may be a useful addition in the treatment of patients with non-insulin-dependent diabetes mellitus.
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PMID:Acarbose treatment of non-insulin-dependent diabetes mellitus. 669 73

Recent investigations point to the nonenzymatic glycosylation as a cause of long-term complications in diabetes mellitus. We describe an enzymatic activity that cleaves glucose from the glomerular basement membrane (GBM), present in lysosomal preparations of diabetic lymphocytes. The GBM, nonenzymatically glycosylated or obtained from rats with diabetes, were incubated with enzyme preparations, separated on Sephadex G-25 and applied for glucose measurement on gas chromatography and mass spectroscopy. The lysosomal preparation of diabetic lymphocytes cleaved from rat GBM, which were nonenzymatically glycosylated 300-500 ng glucose/mg GBM protein, from diabetic rat GBM 300 ng glucose/mg GBM protein. A lysosomal preparation of normal lymphocytes failed to do so, indicating enzyme induction in the diabetic state. Control studies with the glycosylated hemoglobin AIc confirmed this finding and showed the specificity of the enzyme, as alpha-glucosidase and beta-glucosidase failed to cleave the N-glycosidic bond between glucose and the protein. The enzymatic activity can be described formally as a N-l-deoxyfructofuranosyl-glucohydrolase, which could be responsible for a potential reversibility of diabetic GBM changes.
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PMID:Enzymatic reversibility of nonenzymatic glycosylation of the glomerular basement membrane. Is the diabetic glomerulopathy principally reversible? 683 51

Acarbose (Bay g 5421) is a powerful alpha-glucoside hydrolase inhibitor of potential value in the treatment of diabetes and hypoglycemic dumping syndrome after gastric surgery. The extent of its use may be limited by symptoms produced by carbohydrate malabsorption. To minimize these, the action of low doses of acarbose on 24-h blood glucose profiles and hydrogen evolution have been studied on four ambulant volunteers on control diets, after exclusion of sucrose and also after addition of guar in an attempt to enhance the therapeutic effect. Replacement of dietary sucrose by starch abolished significant hydrogen evolution in the morning after low doses of acarbose but did not reduce its effectiveness in decreasing the mean three-meal blood glucose area by 41% (P less than 0.002). Addition of hydrated guar to this diet reduced the mean three-meal glucose area after acarbose further by 72% (P less than 0.001) but increased hydrogen evolution. The results suggest that acarbose will be both effective and acceptable given at low dose when the dietary carbohydrate is starch.
Diabetes Care
PMID:Effect of acarbose on the 24-hour blood glucose profile and pattern of carbohydrate absorption. 692 27

Fifty-gram carbohydrate tolerance tests were performed on healthy volunteers to test the activity and specificity of an alpha-glucoside hydrolase inhibitor, acarbose (BAY g 5421). Two hundred milligrams acarbose reduced the area under the blood glucose response curve by 89% (P less than 0.001) after sucrose by 80% (P less than 0.002) after starch, by 19% (N.S.) after maltose, with no effect on glucose. Breath hydrogen measurements indicated an almost complete malabsorption of the sucrose. At 50 mg acarbose, some reduction in blood glucose and insulin response to sucrose was still seen, but no significant hydrogen production. It is suggested that at lower doses, acarbose may prolong the time course over which carbohydrate is absorbed as does dietary fiber; as with fiber, it may be a useful adjunct to diabetic therapy.
Diabetes 1981 Nov
PMID:Scope and specificity of acarbose in slowing carbohydrate absorption in man. 702 48


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