1. Alpha‐glucosidase inhibitors such as miglitol and acarbose lower blood glucose after a starch load in healthy volunteers and diabetic patients by interfering with the conversion of disaccharide to monosaccharide in the gastrointestinal tract. 2. The effect of placebo, 100 mg miglitol and 100 mg acarbose given 30 min prior to a 75 g oral glucose load was investigated in nine healthy Caucasian volunteers. 3. Miglitol produced a statistically significant fall in post‐peak blood glucose levels when compared with placebo and acarbose. Serum insulin did not change significantly. 4. As miglitol is well absorbed and acarbose is not, it is suggested that miglitol has a systemic hypoglycaemic effect, probably related to its close structural similarity to glucose, which warrants further investigation.

No abstract

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.

BAY m1099 (a 1-deoxynojirimycin derivative) is a glucose analogue which is an alpha-glucosidase inhibitor. Its effects on post-prandial blood glucose and insulin levels was compared with a placebo in 12 healthy male volunteers (6 Blacks and 6 Whites). It produced a similar, significant depression of post-prandial blood glucose and insulin levels when the groups were assessed separately and when the data were pooled. Although blood insulin levels in Whites were higher than in Blacks, as previously reported, the difference was not statistically significant and did not appear to influence the response to the drug. BAY 1099 produced no objective or subjective untoward effects and appears to warrant further investigation as an adjuvant to dietary control of diabetes mellitus.

The effect of a new alpha-glucosidase inhibitor (BAY m 1099), a 1-deoxynojirimycin derivative, was studied in 10 black patients with Type II diabetes mellitus. It produced significant lowering of blood glucose concentration after standardized maize porridge meals. No significant untoward effects were noted. BAY m 1099 appears to offer potential benefit in the management of Type II diabetics, and more extensive clinical investigation is warranted.