Monotherapy of α-
glucosidase inhibitor (α-GI) or
dipeptidyl peptidase 4 (
DPP4) inhibitor does not sufficiently minimize
glucose fluctuations in the diabetic state. In the present study, we evaluated the combined effects of various of α-GI inhibitors (
acarbose,
voglibose or
miglitol) and
sitagliptin, a
DPP4 inhibitor, on
blood glucose fluctuation,
insulin and active
glucagon-like peptide-1 (GLP-1) levels after nutriment loading in mice.
Miglitol and
sitagliptin elicited a 47% reduction (P < 0.05) of the area under the curve of
blood glucose levels for up to 2 h after
maltose-loading, a 60% reduction (P < 0.05) in the range of
blood glucose fluctuation, and a 32% decrease in plasma
insulin compared with the control group. All three of the combinations elicited a 2.5-4.9-fold synergistic increase in active
GLP-1 (P < 0.05 vs control). Thus, combined treatment with the α-GI
miglitol, which more strongly inhibits the early phase of
postprandial hyperglycemia, and
DPP4 inhibitor yields both complementary and synergistic effects, and might represent a superior anti-hyperglycemic
therapy. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.00081.x, 2011).