The Effect of the Timing and the Administration of Acarbose on Postprandial Hyperglycaemia

Abstract

To clarify the optimum timing for ingestion of acarbose, a 100 mg dose of this oral hypoglycaemic agent was administered 30 min before, at the beginning, and 15 min after ingestion of a test meal, and the effects of the drug on blood glucose rises were compared with increases observed after a control meal (no drug). Twenty-four patients with Type 2 diabetes were included in a randomized, open, cross-over study. The smallest increases in blood glucose (p < 0.001) occurred when acarbose was taken at the beginning and 15 min after starting the test meal (3.3 +/- 1.6 mmol l-1 and 3.3 +/- 1.4 mmol l-1). The increase in blood glucose levels when acarbose was taken 30 min before the test meal was significantly higher (4.2 +/- 1.8 mmol l-1) and it was at its maximum following the control meal (5.2 +/- 1.7 mmol l-1). Similar results were observed when the effects of acarbose on insulin and C-peptide levels were measured. It is recommended that patients should be instructed to take acarbose with their first mouthful of food.

Divided-Dose Administration of Miglitol just before and 15 Minutes after the Start of a Meal Smoothes Postprandial Plasma Glucose Excursions and Serum Insulin Responses in Healthy Men

“…Attenuation of the postprandial insulin secretion is crucial in type 2 diabetic patients, because excess insulin secretion may lead to obesity. In this connection, administration of acarbose at 15 min after the start of a meal reduced postprandial increase of the serum insulin levels in type 2 diabetic patients [18]. Our corresponding (intake schedule 2) results for miglitol in healthy subjects was consistent with those reported in the literature.…”

“…In this connection, Rosak et al reported that the maximum glucose-lowering effect of acarbose was obtained when the drug was administered at the start of a meal or within 15 min after the start of a meal in type 2 diabetic patients [18]. Asakura et al reported that acarbose was effective when administered within 30 min after the start of a meal in healthy subjects or subjects with IGT [19].…”

Study on the Postprandial Glucose Responses to a Chlorogenic Acid-Rich Extract of Decaffeinated Green Coffee Beans in Rats and Healthy Human Subjects

“…After a 30 min infusion, intact chlorogenic acid was found in the gastric vein and aorta, showing that it is quickly absorbed in the rat stomach. In addition, 5-CQAs and caffeic acid were also absorbed in the small intestine challenge, however, did not produce a similar effect but more closely resembled the inhibition of postprandial blood glucose by acarbose, the most widely investigated alphaglycosidase inhibitor (Rosak et al, 1995). While the mechanisms for these observations are unknown, it is conceivable that the effect of EDGCB depends on chlorogenic acid molecules reaching the upper small intestine at the same time as the intestinal contents.…”

Comparison of pre‐ vs. postmeal administration of miglitol for 3 months in type 2 diabetic patients

“…Previously, the single administration of acarbose within 15 or 30 min after the start of a meal was shown to decrease plasma glucose levels in two separate studies [6,7]. Despite these findings, diabetic patients are usually advised to take aGIs just before a meal.…”