Relationship between gastric emptying and an alpha-glucosidase inhibitor effect on postprandial hyperglycemia in NIDDM patients.

Abstract

OBJECTIVE:

The purpose of the study was to examine the relationship between gastric emptying and the efficacy of an alpha-glucosidase inhibitor in NIDDM patients.

RESEARCH DESIGN AND METHODS:

Sixteen NIDDM patients (4 patients treated with diet therapy alone and 12 receiving a sulfonylurea) were given 0.6 mg of voglibose daily for 4 weeks. The efficacy of voglibose was assessed by measurement of HbA1c, fasting plasma glucose, and 45- and 120-min postprandial plasma glucose (PPG) and serum insulin concentrations before and after the 4 weeks of voglibose therapy. Gastric emptying was evaluated using the proportional cumulative area under the absorption curve (% AUC) of plasma acetaminophen concentration at 60 min after ingestion of a liquid test meal containing 20 mg/kg of acetaminophen. These measurements were also taken before and after the therapy.

RESULTS:

The change in the 45-min PPG levels from the fasting state correlated significantly with the % AUC of the plasma acetaminophen concentrations (r = 0.625, P = 0.0096) before the voglibose administrations. The mean 45-min and 2-h PPG levels were reduced significantly after 4 weeks of voglibose (P < 0.05 and P < 0.01, respectively). Two-hour postprandial serum insulin concentrations were also significantly reduced at the end of the treatment period (P < 0.05). The changes in the PPG levels between pre- and posttreatment periods correlated significantly with the % AUC of the plasma acetaminophen concentrations before the treatment period (r = 0.499, P = 0.0490; r = 0.713, P = 0.0019, respectively). There was no significant difference in the plasma acetaminophen concentrations between pre- and posttreatment periods.

CONCLUSIONS:

The rate of gastric emptying affects the efficacy of voglibose therapy in NIDDM patients. Voglibose did not however alter the rate of gastric emptying.

• Authors: T Kawagishi, Y Nishizawa, H Taniwaki, S Tanaka, Y Okuno, M Inaba, E Ishimura, M Emoto, H Morii
• Journal: Diabetes care (Diabetes Care) Vol. 20 Issue 10 Pg. 1529-32 (Oct 1997) ISSN: 0149-5992 [Print] United States
• PMID: 9314629 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Blood Glucose
• Enzyme Inhibitors
• Glycoside Hydrolase Inhibitors
• Insulin
• Acetaminophen
• Inositol
• voglibose

Topics

• Acetaminophen (blood, pharmacokinetics)
• Blood Glucose (drug effects, metabolism)
• Diabetes Mellitus, Type 2 (blood, physiopathology)
• Enzyme Inhibitors (therapeutic use)
• Female
• Gastric Emptying (drug effects, physiology)
• Glycoside Hydrolase Inhibitors
• Humans
• Inositol (analogs & derivatives, therapeutic use)
• Insulin (blood)
• Male
• Metabolic Clearance Rate
• Middle Aged
• Postprandial Period
• Regression Analysis