Low‐dose acarbose does not delay digestion of starch but reduces its bioavailability

Wachters-Hagedoorn, Renate E.; Priebe, Marion; Heimweg, Janneke; Heiner, AM; Elzinga, Harmke; Stellaard, Frans; Vonk, Roelf

doi:10.1111/j.1464-5491.2007.02115.x

Cited by 27 publications

(27 citation statements)

References 47 publications

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“…75‐g OGTT or standard Japanese meal) by ~8% to 14% 24. This decrease is modest when compared to an oral antihyperglycaemic agent such as acarbose, which has shown reductions of ~31% to 58% on postprandial glycaemia when administered with a meal load 45, 46…”

Section: Discussionmentioning

confidence: 99%

The effect of small doses of fructose and allulose on postprandial glucose metabolism in type 2 diabetes: A double‐blind, randomized, controlled, acute feeding, equivalence trial

Noronha

Braunstein

Glenn

et al. 2018

Diabetes Obesity Metabolism

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AimTo assess and compare the effect of small doses of fructose and allulose on postprandial blood glucose regulation in type 2 diabetes.MethodsA double‐blind, multiple‐crossover, randomized, controlled, acute feeding, equivalence trial in 24 participants with type 2 diabetes was conducted. Each participant was randomly assigned six treatments separated by >1‐week washouts. Treatments consisted of fructose or allulose at 0 g (control), 5 g or 10 g added to a 75‐g glucose solution. A standard 75‐g oral glucose tolerance test protocol was followed with blood samples at −30, 0, 30, 60, 90 and 120 minutes. The primary outcome measure was plasma glucose incremental area under the curve (iAUC).ResultsAllulose significantly reduced plasma glucose iAUC by 8% at 10 g compared with 0 g (717.4 ± 38.3 vs. 777.5 ± 39.9 mmol × min/L, P = 0.015) with a linear dose response gradient between the reduction in plasma glucose iAUC and dose (P = 0.016). Allulose also significantly reduced several related secondary and exploratory outcome measures at 5 g (plasma glucose absolute mean and total AUC) and 10 g (plasma glucose absolute mean, absolute and incremental maximum concentration [Cmax], and total AUC) (P < .0125). There was no effect of fructose at any dose. Although allulose showed statistically significant reductions in plasma glucose iAUC compared with fructose at 5 g, 10 g and pooled doses, these reductions were within the pre‐specified equivalence margins of ±20%.ConclusionAllulose, but not fructose, led to modest reductions in the postprandial blood glucose response to oral glucose in individuals with type 2 diabetes. There is a need for long‐term randomized trials to confirm the sustainability of these improvements.

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Section: Discussionmentioning

confidence: 99%

The effect of small doses of fructose and allulose on postprandial glucose metabolism in type 2 diabetes: A double‐blind, randomized, controlled, acute feeding, equivalence trial

Noronha

Braunstein

Glenn

et al. 2018

Diabetes Obesity Metabolism

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show abstract

“…The derivatization of plasma glucose to glucose penta-acetate for the analysis of the isotopic enrichment of plasma glucose is described in detail elsewhere (16). The 13 C/ 12 C isotope ratio measurement of the glucose pentaacetate derivative was determined by gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS) (TracerMAT; Thermo Finnigan, Bremen, Germany), and 2 H enrichment was measured by gas chromatography/mass spectrometry (GC/MS) under conditions previously described (17,18). SCFAs were measured by GC/MS as described by Morrison et al (19).…”

Section: Analytic Proceduresmentioning

confidence: 99%

Factors related to colonic fermentation of nondigestible carbohydrates of a previous evening meal increase tissue glucose uptake and moderate glucose-associated inflammation

Priebe¹,

Wang²,

Weening³

et al. 2010

The American Journal of Clinical Nutrition

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“…The significantly more marked decrease in blood sugar with less insulin under the combination of acarbose with insulinotropic substances is not only due to reduced absorption of glucose over time [43], but also to increased insulin sensitivity of the metabolic target organs under acarbose. The postprandial insulin concentration was reduced by up to 60% and insulin resistance by 30% in a group of older patients after 1 year's treatment [46,89].…”

Section: Proinsulin and Insulin Secretion With Combination Therapy Wimentioning

confidence: 94%

“…The blood glucose concentration measured postprandially is therefore preceded by the principal effect of acarbose on the alpha-glucosidases, with the attendant effects on the increase in blood glucose, proinsulin and insulin secretion [40][41][42]. Recent publications confirm the decreased insulin secretion [43][44][45][46].…”

Section: Influencing Proinsulin and Insulin Secretion By The Mode Of mentioning

confidence: 99%

Effects of Acarbose on Proinsulin and Insulin Secretion and their Potential Significance for the Intermediary Metabolism and Cardiovascular System

Rosak¹,

Mertes

2009

CDR

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The alpha-glucosidase inhibitor acarbose is administered to control blood glucose levels in type 2 diabetic patients and, in several countries, in those with impaired glucose tolerance. The efficacy and safety of the drug has been well established in these patient populations. Acarbose shows no weakening of efficacy in long-term diabetes treatment, reduces the development of type 2 diabetes in those with impaired glucose tolerance, and also appears to reduce the risk of cardiovascular disease. The underlying mechanisms of its effect on the risk of developing macrovascular complications have still to be elucidated. The mode of action of acarbose, which precedes all other metabolic processes involved in blood glucose regulation, inhibits high increases in postprandial blood glucose. Due to this early mode of action, acarbose also modifies insulin and proinsulin secretion which are both involved in ss-cell dysfunction and insulin resistance and may be independent risk factors for cardiovascular mortality. Based on the literature available the present state of knowledge on insulin and proinsulin as risk factors for cardiovascular mortality is reviewed as well as the effect of acarbose on the regulation of the ss-cells as monotherapy and in combination regimens. Possible associated interactions with the cardiovascular system are identified.

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Low‐dose acarbose does not delay digestion of starch but reduces its bioavailability

Cited by 27 publications

References 47 publications

The effect of small doses of fructose and allulose on postprandial glucose metabolism in type 2 diabetes: A double‐blind, randomized, controlled, acute feeding, equivalence trial

The effect of small doses of fructose and allulose on postprandial glucose metabolism in type 2 diabetes: A double‐blind, randomized, controlled, acute feeding, equivalence trial

Factors related to colonic fermentation of nondigestible carbohydrates of a previous evening meal increase tissue glucose uptake and moderate glucose-associated inflammation

Effects of Acarbose on Proinsulin and Insulin Secretion and their Potential Significance for the Intermediary Metabolism and Cardiovascular System

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