The Effect of an α-Glucosidase Inhibitor and Insulin on Glucose Metabolism and Lipid Profiles in Non-Insulin-Dependent Diabetes Mellitus

1996 ◽  
Vol 24 (5) ◽  
pp. 438-447 ◽  
Author(s):  
S Okada ◽  
K Ishii ◽  
H Hamada ◽  
S Tanokuchi ◽  
K Ichiki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Insulin Dose ◽  
Insulin Dependent Diabetes Mellitus ◽  
Lipid Profiles ◽  
Glycosylated Haemoglobin ◽  
Postprandial Blood Glucose ◽  
Dependent Diabetes Mellitus ◽  
Glucosidase Inhibitor ◽  
Insulin Dependent

Studies were carried out to assess various ways of improving glycaemic control and lipid profiles of patients with non-insulin-dependent diabetes mellitus (NIDDM) in whom glucose metabolism was poor. Part or all of the dose of the sulphonylurea that had been used to treat patients in Group 1 ( n = 8) was replaced by an α-glucosidase inhibitor. Symptoms related to hypoglycaemia disappeared and the postprandial blood glucose level was significantly increased ( P < 0.043) but serum lipid levels were not significantly altered and the mean glycosylated haemoglobin level was unchanged. In Group 2 ( n = 10) patients, a large part of the insulin dose was replaced by an α-glucosidase inhibitor. Hypoglycaemia-related symptoms disappeared but there were no significant changes in lipid profiles, postprandial blood glucose or glycosylated haemoglobin levels. The third group of patients ( n = 9) had been treated with insulin alone and were given additional α-glucosidase inhibitor without changing their insulin dose. This did not significantly change their lipid profiles, postprandial blood glucose or glycosylated haemoglobin levels. In Group 4 ( n = 9) the addition of an α-glucosidase inhibitor to the initial sulphonylurea did not produce any significant changes in mean postprandial blood glucose or glycosylated haemoglobin levels. The results for individual patients indicated that the glycosylated haemoglobin levels had improved after the change of treatment only in those patients whose connective peptide immunoreactivity was > 6.0 ng/ml.

The Effect of a Very Low Dose of Tolbutamide Combined with an α-Glucosidase Inhibitor in Non-Insulin-Dependent Diabetes Mellitus

1996 ◽  
Vol 24 (5) ◽  
pp. 433-437 ◽  
Author(s):  
S Okada ◽  
K Ishii ◽  
H Hamada ◽  
S Tanokuchi ◽  
K Ichiki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Low Dose ◽  
Combined Treatment ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Postprandial Blood Glucose ◽  
Dependent Diabetes Mellitus ◽  
Glycosylated Haemoglobin Level ◽  
Glucosidase Inhibitor ◽  
Insulin Dependent

The effect of adding a very low dose of a sulphonylurea (tolbutamide) to the treatment of 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) was investigated. Patients took 0.1 mg tds of an α-glucosidase inhibitor orally for 8 weeks, and 50 mg tds of the sulphonylurea, tolbutamide, for the last 4 weeks of this period. The glycosylated haemoglobin level was significantly reduced during the combined treatment period compared with the level after treatment with α-glucosidase inhibitor alone ( P = 0.035), although not compared with the pretreatment level. There were no significant changes in postprandial blood glucose, serum lipid levels or connective peptide immunoreactivities. These preliminary results indicate that the addition of a very low dose of tolbutamide to a recommended diet and treatment with an α-glucosidase inhibitor, may improve glucose metabolism without raising insulin secretion or influencing lipid metabolism.

Can α-Glucosidase Inhibitors Reduce the Insulin Dosage Administered to Patients with Non-Insulin-Dependent Diabetes Mellitus?

1995 ◽  
Vol 23 (6) ◽  
pp. 487-491 ◽  
Author(s):  
S Okada ◽  
K Ishii ◽  
H Hamada ◽  
S Tanokuchi ◽  
K Ichiki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Dose ◽  
Sugar Metabolism ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Insulin Dosage ◽  
Dependent Diabetes Mellitus ◽  
Glucosidase Inhibitor ◽  
Glucosidase Inhibitors ◽  
Insulin Dependent

For 10 patients (three women and seven men) with non-insulin-dependent diabetes mellitus, who had been given insulin (22.6 ± 19.6 U/day) and had frequently shown hypo-glycaemia, the insulin dose was slightly reduced and the administration of an α-glucosidase inhibitor was simultaneously started. Hypoglycaemic symptoms disappeared immediately and completely, and sugar metabolism immediately before the withdrawal of treatment was not aggravated: the glycosylated haemoglobin level was unchanged and the post-prandial blood glucose level was increased though not significantly. The results of the present study indicate that the combined use of an α-glucosidase inhibitor with a reduced insulin dose improves the quality of life of patients and may improve hyperinsulinaemia.

Effect of an α-Glucosidase Inhibitor Combined with Sulphonylurea Treatment on Glucose Metabolism in Patients with Non-Insulin-Dependent Diabetes Mellitus

1995 ◽  
Vol 23 (4) ◽  
pp. 279-283 ◽  
Author(s):  
S Okada ◽  
K Ishii ◽  
S Tanokuchi ◽  
H Hamada ◽  
K Ichiki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Insulin Dependent Diabetes Mellitus ◽  
Glycosylated Haemoglobin ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Glucosidase Inhibitor ◽  
Insulin Dependent ◽  
Sulphonylurea Treatment ◽  
Inhibitor Treatment

Ten patients with non-insulin-dependent diabetes mellitus who were being treated with a sulphonylureal compound but whose glucose metabolism needed further improvement were given a combination of their usual sulphonylurea treatment and an α-glucosidase inhibitor. Treatment with the α-glucosidase inhibitor (0.6 mg/day), in addition to glibenclamide (7.5 mg/day in two patients; 5.0 mg/day in four; 2.5 mg/day in one) or tolbutamide (500 mg/day in three patients) for 4 weeks, improved hyperglycaemia after meals from 237 – 247 mg/dl to 192 mg/dl, and reduced glycosylated haemoglobin levels from 8.5 – 8.6% to 7.9% without causing hypoglycaemia.

Oral hypoglycaemics for diabetes: when and which?

1991 ◽  
Vol 29 (4) ◽  
pp. 13-16
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Regular Exercise ◽  
Control Blood Glucose ◽  
District Policy ◽  
Insulin Dependent ◽  
Market Leader

People with non-insulin-dependent diabetes mellitus should modify their diet, avoid obesity and take regular exercise. An oral hypoglycaemic drug may be needed if these measures fail to control blood glucose, but it is now clear that they commonly cause hypoglycaemia. More than 3 million prescriptions were issued in 1988 for the sulphonylureas (eight currently available) and the biguanide, metformin. Glibenclamide is the market leader (1.4 million prescriptions in 1988), followed by metformin (950,000), chlorpropamide (280,000), tolbutamide (260,000) and gliclazide (200,000). Instituting a district policy to restrict the choice of sulphonylureas can improve care and save money.1 No new oral hypoglycaemics have been marketed since we last reviewed them2 but their place in overall management has been clarified.

Is There a Correlation between Cardiac Sympathetic Neuropathy or Diabetic Somatic Neuropathy and Glycosylated Haemoglobin or Blood Pressure in Patients with Non-Insulin-Dependent Diabetes Mellitus?

1995 ◽  
Vol 23 (6) ◽  
pp. 467-472 ◽  
Author(s):  
S Okada ◽  
K Ishii ◽  
H Hamada ◽  
K Ichiki ◽  
S Tanokuchi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Insulin Dependent Diabetes Mellitus ◽  
Glycosylated Haemoglobin ◽  
Dependent Diabetes Mellitus ◽  
Nerve Function ◽  
Insulin Dependent

The possibility that glycosylated haemoglobin levels and/or blood pressure might correlate with cardiac sympathetic neuropathy and/or diabetic somatic neuropathy was investigated in patients with non-insulin-dependent diabetes mellitus. Sympathetic nerve function was quantified by analysis of [123I]metaiodobenzylguanidine accumulation in the cardiac muscle. Somatic nerve function was assessed by measuring the motor nerve conduction velocities of the peroneal and tibial nerves, and the sensory nerve conduction velocity of the sural nerve. None of the parameters of cardiac sympathetic neuropathy or diabetic somatic neuropathy showed any correlation with blood pressure, nor was there any evidence of a correlation between cardiac sympathetic neuropathy and glycosylated haemoglobin levels; there was, however, a significant correlation between diabetic somatic neuropathy (as indicated by tibial nerve conduction velocity) and glycosylated haemoglobin levels. The results are consistent with the view that different mechanisms are involved in the two types of neuropathies.

scholarly journals Lack of physiological suppression of circulating IGFBP-1 in puberty in patients with insulin-dependent diabetes mellitus

2002 ◽  
pp. 235-241 ◽  
Author(s):  
PH Riihimaa ◽  
M Knip ◽  
A Ruokonen ◽  
P Tapanainen
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Body Fat ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Free Insulin ◽  
Total Body Fat ◽  
Insulin Dependent ◽  
Total Body

OBJECTIVE: To evaluate the interaction between serum free insulin, insulin-like binding protein (IGFBP)-1 and leptin concentrations during puberty in insulin-dependent diabetes mellitus (IDDM). DESIGN: Adolescent patients with IDDM (n=101, age >9 years, duration >2 years) from the Outpatient Clinic of the Department of Pediatrics at Oulu University Hospital, and non-diabetic controls, were recruited to the study. Free insulin, IGFBP-1, leptin and insulin antibody concentrations were measured from a fasting serum sample. RESULTS: Free insulin concentrations were lower in the patients than in the controls (4.3+/-2.3 mU/l compared with 6.5+/-3.1 mU/l, P<0.001), and there was an inverse correlation between free insulin and fasting blood glucose in the boys with diabetes (r=-0.53, P<0.001), whereas a positive correlation was observed between free insulin and leptin concentrations in the girls with diabetes (r=0.30, P=0.020). The IGFBP-1 concentrations were greater in the patients than in the controls (16.5+/-10.6 microg/l compared with 4.0+/-3.3, P<0.001), and they correlated significantly with blood glucose (r=0.63, P<0.001) and free insulin (r=-0.35, P<0.001). No significant difference was observed in the leptin concentrations between the patients and controls overall, despite greater total body fat in the girls with diabetes compared with the control girls. CONCLUSIONS: Adolescents with IDDM are characterised by morning hypoinsulinaemia and high circulating IGFBP-1 concentrations, which may contribute to insulin resistance and impaired metabolic control during puberty. The mechanism behind the increased total body fat in the postpubertal female patients remains to be determined.

Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus

1990 ◽  
Vol 30 (3) ◽  
pp. 281-294 ◽  
Author(s):  
E.R.B. Shanmugasundaram ◽  
G. Rajeswari ◽  
K. Baskaran ◽  
B.R.Rajesh Kumar ◽  
K.Radha Shanmugasundaram ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Leaf Extract ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Gymnema Sylvestre ◽  
Insulin Dependent
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