Acarbose-induced acute severe hepatotoxicity

Carrascosa, Miguel F; Pascual, Francisco; Aresti, Santiago

doi:10.1016/s0140-6736(05)60134-1

Cited by 84 publications

(41 citation statements)

References 4 publications

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“…These common adverse effects in association with the use of a-glucosidase inhibitors were considered to result from its mechanism of action as undigested carbohydrate reaches the colon and generates gas by fermentation, which then causes gastrointestinal symptoms such as flatulence, flatus, crepitus, and diarrhea (Baba, 1994). Sometimes ileus has been reported during the treatments with acarbose and voglibose (Ohno, 1995), and acute hepatotoxicity has been observed with acarbose (Carrascosa, 1997;Fujimoto, 1998;Diaz-Gutierrez, 1998) or voglibose (Kawakami et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

Effects of single and long-term administration of wheat albumin on blood glucose control: randomized controlled clinical trials

Kodama

Miyazaki²,

Kitamura

et al. 2004

Eur J Clin Nutr

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Objective: To examine the effects of single and long-term administration of wheat albumin (WA) on blood glucose levels and blood glucose control, respectively. Design: Randomly arranged crossover trial for single administration in healthy subjects and double-blinded randomized controlled trial for long-term administration (3 months) in diabetic patients. In vitro a-amylase inhibitory activity of WA was also determined. Setting: Central Research Laboratories of Nisshin Flour Milling Co. Ltd. (Saitama, Japan) for single administration and Aiwa Clinic (Saitama, Japan) for long-term administration. Subjects: A total of 12 healthy adult male volunteers for the single administration and 24 type II outpatient diabetics with mild hyperglycemia for the long-term administration. Interventions: Subjects took soups containing 0, 0.25, 0.5, and 1.0 g WA before test meals for single administration, and patients took soups with or without 0.5 g WA before every meal for the long-term (3 months) administration. Results: In vitro a-amylase inhibitory activity of WA was 150 times that of wheat flour. In the single administration experiment, WA suppressed peak postprandial blood glucose levels in a dose-dependent manner: 31, 47, and 50% reduction after 0.25, 0.5, and 1.0 g administrations, respectively. In the long-term administration, 0.5 g of WA did not affect fasting blood glucose levels, whereas it reduced hemoglobin A 1 c levels. No significant adverse effects such as hypoglycemia or gastrointestinal disturbances were observed in the two experiments. Conclusion: In the treatment of type II diabetic patients, WA might be a useful functional food, which, with diet and exercise, could help to improve blood glucose control without any critical adverse effects.

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Section: Discussionmentioning

confidence: 99%

Effects of single and long-term administration of wheat albumin on blood glucose control: randomized controlled clinical trials

Kodama

Miyazaki²,

Kitamura

et al. 2004

Eur J Clin Nutr

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“…We have reported that carbohydrate intake plays an important role in the metabolism and toxicity of CCl 4 and that a low-carbohydrate diet potentiates CCl 4 -induced hepatotoxicity, irrespective of the content of protein, fat, or other nutrients in the diet. 19 It is now known that CYP2E1 induction is responsible for the dietary modification of CCl 4 toxicity.…”

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confidence: 99%

“…1,2 However, there are several cases of hepatic failure in patients treated with acarbose reported in the literature. [3][4][5] According to the Japan Ministry of Health and Welfare, 6 57 cases of liver dysfunction in non-insulindependent diabetes mellitus patients treated with acarbose have been reported to the Ministry (2 of these died from fulminant hepatitis).…”

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confidence: 99%

“…AP, which is widely used as an analgesic and antipyretic agent, is also hepatotoxic in very high doses. 15 The hepatotoxicity of CCl 4 16-17 and AP 18 is caused by reactive intermediates (trichloromethyl radical for CCl 4 ; N-acetyl-pbenzoquinoneimine for AP) produced during their metabolism chiefly by CYP2E1 in the liver.…”

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confidence: 99%

“…Ethanol, which is a potent inducer of CYP2E1, 9,21,22 is known to potentiate the hepatotoxicity of both CCl 4 23-27 and AP. [28][29][30][31][32] In addition, a low-carbohydrate intake during ethanol ingestion markedly augments the ethanol-induced potentiation of CCl 4 toxicity.…”

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confidence: 99%

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Acarbose alone or in combination with ethanol potentiates the hepatotoxicity of carbon tetrachloride and acetaminophen in rats

et al. 1999

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Acarbose reduces the absorption of monosaccharides derived from dietary carbohydrates, which play an important role in the metabolism and toxicity of some chemical compounds. We studied the effects of acarbose on the hepatotoxicity of carbon tetrachloride (CCl 4 ) and acetaminophen (AP) in rats, both of which exert their toxic effects through bioactivation associated with cytochrome P450 2E1 (CYP2E1). Male Sprague-Dawley rats were kept on a daily ration (

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α‐Glucosidase Inhibitors

Rabasa‐Lhoret

Chiasson

2004

International Textbook of Diabetes Mellitus

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α‐Glucosidase inhibitors produce a significant reduction of postprandial hyperglycemia and postprandial insulin with a significant decrease of HbA 1c (∼0.7%), by delaying carbohydrate absorption. For diabetic patients, α‐glucosidase inhibitors are safe agents that can be used either as monotherapy or in combination with other oral hypoglycemic agents or insulin. The reduction of HbA 1c should substantially decrease microvascular complications and could diminish macrovascular events. α‐Glucosidase inhibitors should be considered as a treatment of choice for newly diagnosed diabetic patients. For those not well‐controlled with any other type of treatment, it can result in metabolic improvement without any additional risk. To minimize gastrointestinal side effects, treatment should be initiated at a low dose and titrated slowly. In patients with impaired glucose tolerance, acarbose has proven to be efficient in preventing or delaying the occurrence of type 2 diabetes as well as decreasing macrovascular events.

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Acarbose-induced acute severe hepatotoxicity

Cited by 84 publications

References 4 publications

Effects of single and long-term administration of wheat albumin on blood glucose control: randomized controlled clinical trials

Effects of single and long-term administration of wheat albumin on blood glucose control: randomized controlled clinical trials

Acarbose alone or in combination with ethanol potentiates the hepatotoxicity of carbon tetrachloride and acetaminophen in rats

α‐Glucosidase Inhibitors

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