The Efficacy and Safety of Miglitol Therapy Compared With Glibenclamide in Patients With NIDDM Inadequately Controlled by Diet Alone

Segal, P; Feig, Peter U.; Schernthaner, Gerit-Holger; Ratzmann, K P; Rybka, J; Petzinna, Dieter; Berlin, Cheston M.

doi:10.2337/diacare.20.5.687

Cited by 101 publications

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“…1). This is a much smaller effect than that observed in previously reported studies (11,13,22,23,31), in which a reduction in HbA 1c between 0.74 and 1.19% was shown. It is interesting that Johnston et al (11) could not show any better efficacy of miglitol 100 mg three times a day compared with 50 mg three times a day.…”

Section: Conclusion -Previous Studiescontrasting

confidence: 51%

“…have shown the efficacy and safety of miglitol as monotherapy and in combination with sulfonylureas in type 2 diabetes (11,13,18,20,22,23). The present study demonstrates that miglitol in combination with metformin provides a synergistic effect on glycemic control, as indicated by the marked reductions in HbA 1c and plasma glucose levels in middle-aged patients in whom type 2 diabetes is insufficiently controlled by dietary manage- (24).…”

Section: Conclusion -Previous Studiesmentioning

confidence: 54%

“…Miglitol is the first pseudomonosaccharide ␣-glucosidase inhibitor derived from 1-deoxynojirimycin and is structurally a glucose analog (15,16). Its efficacy in monotherapy (13,17) and in combination with sulfonylureas (11) as a glucose-lowering agent in type 2 diabetes has been shown in a number of clinical studies. A study of miglitol in combination with metformin has been reported previously in elderly type 2 diabetic patients (18).…”

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confidence: 99%

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The Synergistic Effect of Miglitol Plus Metformin Combination Therapy in the Treatment of Type 2 Diabetes

Chiasson

Naditch

2001

Diabetes Care

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OBJECTIVE -To investigate the efficacy and safety of miglitol in combination with metformin in improving glycemic control in outpatients in whom type 2 diabetes is insufficiently controlled by diet alone.RESEARCH DESIGN AND METHODS -In this multicenter, double-blind, placebocontrolled study, 324 patients with type 2 diabetes were randomized, after an 8-week placebo run-in period, to treatment with either placebo, miglitol alone, metformin alone, or miglitol plus metformin for 36 weeks. The miglitol was titrated to 100 mg three times a day and metformin was administered at 500 mg three times a day. The primary efficacy criterion was change in HbA 1c from baseline to the end of treatment. Secondary parameters included changes in fasting and postprandial plasma glucose and insulin levels, serum triglyceride levels, and responder rate.RESULTS -A total of 318 patients were valid for intent-to-treat analysis. A reduction in mean placebo-subtracted HbA 1c of Ϫ1.78% was observed with miglitol plus metformin combination therapy, which was significantly different from treatment with metformin alone (Ϫ1.25; P ϭ 0.002). Miglitol plus metformin also resulted in better metabolic control than metformin alone for fasting plasma glucose (Ϫ44.8 vs. Ϫ20.4 mg/dl; P ϭ 0.0025), 2-h postprandial glucose area under the curve (Ϫ59.0 vs. -18.0 mg/dl; P ϭ 0.0001), and responder rate (70.6 vs. 45.52%; P ϭ 0.0014). All therapies were well tolerated.CONCLUSIONS -In type 2 diabetic patients, miglitol in combination with metformin gives greater glycemic improvement than metformin monotherapy. Diabetes Care 24:989 -994, 2001

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Section: Conclusion -Previous Studiescontrasting

confidence: 51%

Section: Conclusion -Previous Studiesmentioning

confidence: 54%

mentioning

confidence: 99%

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The Synergistic Effect of Miglitol Plus Metformin Combination Therapy in the Treatment of Type 2 Diabetes

Chiasson

Naditch

2001

Diabetes Care

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“…Os inibidores competitivos da alfa-glicosidase, como a acarbose, o miglitol e a voglibose agem como antagonistas enzimáticos da amilase e sucrase e diminuem a absorção intestinal da glicose (18,19). Estas medicações não interferem na secreção de insulina, e diminuem a glicemia de jejum e a hiperglicemia pós-prandial.…”

Section: Inibidores Da Alfa-glicosidaseunclassified

Tratamento do diabetes mellitus do tipo 2: novas opções

Araújo

Britto

Cruz

2000

Arq Bras Endocrinol Metab

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RESUMOO diabetes mellitus do tipo 2 (DM2) resulta de defeitos na secreção e ação da insulina. Ele está freqüentemente associado à resistência à insulina, obesidade andróide, dislipidemia e hipertensão arterial, constituindo a síndrome metabólica. O tratamento atual visa diminuir a resistência à insulina e melhorar a função da célula beta pancreática com dieta, exercícios, hipoglicemiantes orais, anti-hiperglicemiantes e/ou drogas anti-obesidade. Novas drogas no tratamento do DM estão surgindo, tornando possíveis múltiplas opções terapêuticas. Este artigo apresenta uma revisão sobre o assunto. ABSTRACTType 2 diabetes mellitus results from defects in both insulin action and insulin secretion. It is frequently associated with hyperinsulinemia, central obesity, dyslipidemia and arterial hypertension, components of the so-called metabolic syndrome. The main targets of the treatment are to decrease insulin resistance and improve beta cell function with diet, exercise, oral hypoglycemic and anti-hyperglycemic agents and/or anti-obesity drugs. New drugs for the treatment of diabetes mellitus make possible multiples therapeutics options. This article reviews this subject. O DIABETES MELLITUS DO TIPO 2 (DM2) ou não insulino-dependente e a intolerância à glicose têm se tornado um dos distúrbios mais comuns em clínica médica e estão freqüentemente associados à síndrome metabólica, que se caracteriza por resistência à insulina, obesidade andróide ou central, dislipidemia e hipertensão arterial (1,2). A síndrome metabólica é responsável pela maior morbi-mortalidade por doenças cardiovasculares tanto em obesos quanto em diabéticos tipo 2.O tratamento atual do DM2 visa manter o controle glicêmico adequado, seja com dieta hipocalórica, aumento da prática de exercícios físi-cos ou uso de medicações. Existem no momento diversas opções terapêu-ticas, que podem ser utilizadas isoladamente ou em associações: sensibilizadores da ação de insulina (metformina, tiazolidinedionas), anti-hiperglicemiantes (acarbosc), secretagogos (sulfoniluréias, repaglinida, nateglinida), drogas anti-obesidade e/ou insulina. O Diabetes Control and Complications Trial (DCCT) (3), um estudo prospectivo multicêntrico sobre as diversas formas de tratamento com insulina no DM1 e, mais recentemente,

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“…Disaccharidase inhibitors like acarbose and miglitol effectively compensate for defective early phase insulin release by inhibiting post-prandial absorption of monosaccharides [Lembcke et al, 1990]. The overall glucose-lowering effect of these agents is somewhat inferior to that of the sulfonylureas [Segal et al, 1997], but the effect on postprandial hyperglycemia is much greater than on fasting glucose levels [Johnston et al, 1988].…”

Section: Pharmacoglogical Treatmentmentioning

confidence: 99%

Postprandial hyperglycemia: Why do we care about it? What should we do?

Rendell

2006

Drug Development Research

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There is increasing evidence that elevated postprandial plasma glucose (PPG) exerts a more deleterious effect on the vascular system than elevation of fasting plasma glucose (FPG). In particular, individuals with normal FPG but impaired glucose tolerance (IGT) have significantly increased risk of cardiovascular events. With the recognition of the importance of PPG and the availability of new pharmacologic options, management of diabetes will shift to greater attention to PPG levels. There are many approaches to reduction of PPG; dietary management and promotion of exercise are very effective. Sulfonylureas, meglitinides, metformin, thiazolidinediones, and disaccharidase inhibitors all counteract PPG elevation. The development of glucagon-like peptide-1 (GLP-1) agonists such as exendin and dipeptidyl peptidase IV inhibitors offers a new approach to suppression of PPG elevation. New semisynthetic insulin analogues permit a more aggressive response to post-prandial glucose elevation, with lower risk of hypoglycemia, than with regular insulin. The advent of accurate continuous glucose monitoring will facilitate the treatment of post-prandial hyperglycemia. Drug Dev. Res. 67:582-586, 2006.

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The Efficacy and Safety of Miglitol Therapy Compared With Glibenclamide in Patients With NIDDM Inadequately Controlled by Diet Alone

Cited by 101 publications

References 0 publications

The Synergistic Effect of Miglitol Plus Metformin Combination Therapy in the Treatment of Type 2 Diabetes

The Synergistic Effect of Miglitol Plus Metformin Combination Therapy in the Treatment of Type 2 Diabetes

Tratamento do diabetes mellitus do tipo 2: novas opções

Postprandial hyperglycemia: Why do we care about it? What should we do?

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