No Relationship Between Carbohydrate Intake and Effect of Acarbose on HbA1c or Gastrointestinal Symptoms in Type 2 Diabetic Subjects Consuming 30–60% of Energy From Carbohydrate

Wolever, Thomas M. S.; Chiasson, Jean‐Louis; Josse, Robert G.; Hunt, John A.; Palmason, Carol; Rodger, N. W.; Ross, Samir A.; Ryan, E. A.; Tan, Meng H.

doi:10.2337/diacare.21.10.1612

Cited by 25 publications

(9 citation statements)

References 26 publications

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“…Acarbose was the first member of this class and its clinical use is well reviewed [203][204][205]. The side effects and safety of acarbose have also been examined [206,207]. Voglibose has been evaluated in NIDDM patients and in combination with pioglitazone in GK rats [208,209].…”

Section: Glycosidase Inhibitorsmentioning

confidence: 99%

Current Therapies and Emerging Targets for the Treatment of Diabetes

Wagman¹,

Nuss²

2001

CPD

155

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Concurrent with the spread of the western lifestyle, the prevalence of all types of diabetes is on the rise in the world's population. The number of diabetics is increasing by 4-5% per year with an estimated 40-45% of individual's over the age of 65 years having either type II diabetes or impaired glucose tolerance. Since the signs of diabetes are not immediately obvious, diagnosis can be preceded by an extended period of impaired glucose tolerance resulting in the prevalence of beta-cell dysfunction and macrovascular complications. In addition to increased medical vigilance, diabetes is being combatted through aggressive treatment directed at lowering circulating blood glucose and inhibiting postprandial hyperglycemic spikes. Current strategies to treat diabetes include reducing insulin resistance using glitazones, supplementing insulin supplies with exogenous insulin, increasing endogenous insulin production with sulfonylureas and meglitinides, reducing hepatic glucose production through biguanides, and limiting postprandial glucose absorption with alpha-glucosidase inhibitors. In all of these areas, new generations of small molecules are being investigated which exhibit improved efficacy and safety profiles. Promising biological targets are also emerging such as (1) insulin sensitizers including protein tyrosine phosphatase-1B (PTP-1B) and glycogen synthase kinase 3 (GSK3), (2) inhibitors of gluconeogenesis like pyruvate dehydrogenase kinase (PDH) inhibitors, (3) lipolysis inhibitors, (4) fat oxidation including carnitine palmitoyltransferase (CPT) I and II inhibitors, and (5) energy expenditure by means of beta 3-adrenoceptor agonists. Also important are alternative routes of glucose disposal such as Na+-glucose cotransporter (SGLT) inhibitors, combination therapies, and the treatment of diabetic complications (eg. retinopathy, nephropathy, and neuropathy). With may new opportunities for drug discovery, the prospects are excellent for development of innovative therapies to effectively manage diabetes and prevent its long term complications. This review highlights recent (1997-2000) advances in diabetes therapy and research with an emphasis on small molecule drug design (275 references).

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Section: Glycosidase Inhibitorsmentioning

confidence: 99%

Current Therapies and Emerging Targets for the Treatment of Diabetes

Wagman¹,

Nuss²

2001

CPD

155

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“…During the last week of the study, subjects completed a 3-d diet record that was handed in at the last visit. A symptom questionnaire was administered at baseline and week 4, with the severity of symptoms over the past 4 wk being rated as none, mild, moderate, or severe (34).…”

Section: Methodsmentioning

confidence: 99%

Physicochemical properties of oat β-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial

Wolever

Tosh²,

Gibbs³

et al. 2010

The American Journal of Clinical Nutrition

346

216

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Background: Consumption of 3 g oat b-glucan/d is considered sufficient to lower serum LDL cholesterol, but some studies have shown no effect. LDL cholesterol lowering by oat b-glucan may depend on viscosity, which is controlled by the molecular weight (MW) and amount of oat b-glucan solubilized in the intestine (C). Objectives: Our 2 primary objectives were to determine whether consumption of 3 g high-MW oat b-glucan/d would reduce LDL cholesterol and whether LDL cholesterol lowering was related to the log(MW · C) of oat b-glucan. Design: In a double-blind, parallel-design, multicenter clinical trial, subjects with LDL cholesterol 3.0 and 5.0 mmol/L (n = 786 screened, n = 400 ineligible, n = 19 refused, n = 367 enrolled, and n = 345 completed) were randomly assigned to receive cereal containing wheat fiber (n = 87) or 3 g high-MW (2,210,000 g/mol, n = 86), 4 g medium-MW (850,000 g/mol, n = 67), 3 g medium-MW (530,000 g/mol, n = 64), or 4 g low-MW (210,000 g/mol, n = 63) oat b-glucan/d (divided doses, twice daily) for 4 wk. Results: LDL cholesterol was significantly less with 3 g high-MW, 4 g medium-MW, and 3 g medium-MW oat b-glucan cereals than with the wheat-fiber cereal by 0.21 (5.5%; 95% CI: 20.11, 20.30; P = 0.002), 0.26 (6.5%; 95% CI: 20.14, 20.37; P = 0.0007), and 0.19 (4.7%; 95% CI: 20.08, 20.30; P = 0.01) mmol/L, respectively. However, the effect of 4 g low-MW oat b-glucan/d (0.10 mmol/L) was not significant (2.3%; 95% CI: 0.02, 20.20). By analysis of covariance, log(MW · C) was a significant determinant of LDL cholesterol (P = 0.003). Treatment effects were not significantly influenced by age, sex, study center, or baseline LDL cholesterol. Conclusions: The physicochemical properties of oat b-glucan should be considered when assessing the cholesterol-lowering ability of oat-containing products; an extruded breakfast cereal containing 3 g oat b-glucan/d with a high-MW (2,210,000 g/mol) or a medium-MW (530,000 g/mol) lowered LDL cholesterol similarly by '0.2 mmol/L (5%), but efficacy was reduced by 50% when MW was reduced to 210,000 g/mol. This trial was registered at www.clinicaltrials.gov as NCT00981981.Am J Clin Nutr 2010;92:723-32.

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“…A good curative effect of acarbose is achieved on the basis of carbohydrate quantity in food. Carbohydrate ratio in Chinese food is higher than that of westerners so acarbose controls blood glucose better in Chinese patients rather than the counterpart in Europe and America (3). Chewable tablets refer to pills chewed in the mouth before swallowing.…”

Section: Introductionmentioning

confidence: 99%