Glibenclamide, but Not Acarbose, Increases Leptin Concentrations Parallel to Changes in Insulin in Subjects With NIDDM

Haffner, Steven M.; Hanefeld, Markolf; Fischer, Sabine; Fücker, K.; Leonhardt, W.

doi:10.2337/diacare.20.9.1430

Cited by 35 publications

(16 citation statements)

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“…The decrease in BMI with miglitol is consistent with previous studies [9,19] and could provide an advantage over sulfonylurea [19,20]. This is to our knowledge the first to report the favorable effect of α-glucosidase inhibitors on adiponectin, although an adverse effect of weight gain by glibenclamide on increasing leptin concentrations has been reported in comparison with acarbose [20]. The increase in BMI with mitiglinide is consistent with findings on the meglitinides [21].…”

Section: Discussionsupporting

confidence: 93%

Miglitol increases the adiponectin level and decreases urinary albumin excretion in patients with type 2 diabetes mellitus

Yokoyama¹,

Kannno²,

Ishimura³

et al. 2007

Metabolism

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Section: Discussionsupporting

confidence: 93%

Miglitol increases the adiponectin level and decreases urinary albumin excretion in patients with type 2 diabetes mellitus

Yokoyama¹,

Kannno²,

Ishimura³

et al. 2007

Metabolism

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“…In experiment 2, the lack of difference in baseline leptin concentration between 0700 h and 2200 h is in apparent disagreement with those studies showing a peak in leptin concentration around midnight and a nadir around 10.00 h (12,22,29,30). There is a nocturnal increase in leptin, however, which is related to the insulin response to meals.…”

Section: Discussioncontrasting

confidence: 54%

No acute response of leptin to an oral fat load in obese patients and during circadian rhythm in healthy controls

Guerci

Hadjadj²,

Quilliot³

et al. 2000

European Journal of Endocrinology

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This study was done to elucidate the relationship between postprandial leptin and obesity, and the possible influence of the circadian rhythm on the dynamic leptin response to an oral fat load (OFLT). In experiment 1, we measured the leptin and insulin responses to an oral fat load in 16 non-diabetic obese subjects and in 16 healthy controls, matched for age and gender. In experiment 2, we measured the leptin and insulin responses to an OFLT according to the time of fat load ingestion: 0700 h (diurnal (D) test) or 2200 h (nocturnal (N) test) in nine normal-weight healthy males. Baseline leptin concentration was correlated with the body mass index, body fat mass and percentage of body fat mass in both experiments. The leptin concentrations were higher in women than in men P , 0X001X In experiment 1, the leptin concentrations were higher in obese subjects than in controls, but did not change over time in either group. The plasma insulin concentrations at baseline and during the postprandial state, as well as the area under the curve (AUC) of insulin, were higher in obese subjects than in controls P , 0X05 2 0X0001X There was no correlation between postprandial insulin responses and postprandial leptin responses in either obese or control groups. In experiment 2, leptin (D vs N, 2X9^1X4 vs 2X9^1X0 ngaml) and insulin (D vs N, 41^18 vs 25^9 pmolal) concentrations were similar at the beginning of the D and N tests after a 10 h fast. The leptin concentrations did not change after D or N tests and were not statistically different for D and N tests. Our results indicate that the leptin concentration in healthy controls and in obese patients is not acutely influenced by a high fat load.

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“…The overall comparison of acarbose with sulfonylurea yielded a nonsignificant advantage for sulfonylurea with respect to overall GHb of 0.38% (data not shown; online appendix C). However, seven of the studies in the meta-analyses used unequal comparators, because they compared a fixed dose of acarbose with individually adjusted dosages of sulfonylurea (24, 30,35,44,47,49) or a usual dose of acarbose with a very low dose of glibenclamide (32). The results for the subgroup "acarbose 100 mg versus glibenclamide 3.5 mg" were not consistent with the other comparisons.…”

Section: Glycemic Controlmentioning

confidence: 94%

α-Glucosidase Inhibitors for Patients With Type 2 Diabetes

et al. 2005

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OBJECTIVE -To review the effects of monotherapy with ␣-glucosidase inhibitors (AGIs) for patients with type 2 diabetes, with respect to mortality, morbidity, glycemic control, insulin levels, plasma lipids, body weight, and side effects. RESEARCH DESIGN AND METHODS -We systematically searched the CochraneCentral register of Controlled Trials, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, and reference lists, and we contacted experts and manufacturers. Inclusion criteria were randomized controlled trials of at least 12 weeks' duration, AGI monotherapy compared with any intervention, and one of the following outcome measures: mortality, morbidity, GHb, blood glucose, lipids, insulin levels, body weight, or side effects. Two independent reviewers assessed all abstracts, extracted all data, and assessed quality. We contacted all authors for data clarification. Continuous data were expressed as weighted mean differences and analyzed with a random-effects model. Possible influences of study characteristics and quality were assessed in sensitivity and meta-regression analyses.RESULTS -Forty-one studies were included in the review (30 acarbose, 7 miglitol, 1 voglibose, and 3 combined), and heterogeneity was limited. We found no evidence for an effect on mortality or morbidity. Compared with placebo, AGIs had a beneficial effect on GHb (acarbose Ϫ0.77%; miglitol Ϫ0.68%), fasting and postload blood glucose and postload insulin. With acarbose dosages higher than 50 mg t.i.d., the effect on GHb was the same, but the occurrence of side effects increased. Acarbose decreased the BMI by 0.17 kg/m 2 (95% CI 0.08 -0.26). None of the AGIs had an effect on plasma lipids. Compared with sulfonylurea, AGIs seemed inferior with respect to glycemic control, but they reduced fasting and postload insulin levels. For comparisons with other agents, little data were available.CONCLUSIONS -We found no evidence for an effect on mortality or morbidity. AGIs have clear beneficial effects on glycemic control and postload insulin levels but not on plasma lipids. There is no need for dosages higher than 50 mg acarbose t.i.d. Diabetes Care 28:166 -175, 2005A lpha-glucosidase inhibitors (AGIs; acarbose, miglitol, voglibose) are widely used in the treatment of patients with type 2 diabetes. AGIs delay the absorption of carbohydrates from the small intestine and thus have a lowering effect on postprandial blood glucose and insulin levels.In modern medicine, the efficacy of an intervention should be investigated in well-designed randomized trials. Results from the trials should be collected in a high-quality systematic review, if possible with a meta-analysis. And finally, the evidence should have its repercussions on practice guidelines.How does this apply for AGIs? Recommendations on when to use AGIs and the evidence used for these recommendations appear to be different in various guidelines. For example, the guideline by the European Diabetes Policy Group (1) and a consensus statement by the American Diabetes Association (2)...

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Glibenclamide, but Not Acarbose, Increases Leptin Concentrations Parallel to Changes in Insulin in Subjects With NIDDM

Abstract: Glibenclamide increases circadian leptin and insulin concentrations, whereas acarbose does not. This observation may help to explain weight gain in subjects treated with glibenclamide and stable weight in those treated with acarbose in the long run.

Cited by 35 publications

References 0 publications

Miglitol increases the adiponectin level and decreases urinary albumin excretion in patients with type 2 diabetes mellitus

Miglitol increases the adiponectin level and decreases urinary albumin excretion in patients with type 2 diabetes mellitus

No acute response of leptin to an oral fat load in obese patients and during circadian rhythm in healthy controls

α-Glucosidase Inhibitors for Patients With Type 2 Diabetes

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