Effect of Miglitol, an α-Glucosidase Inhibitor, on Postprandial Glucose and Lipid Metabolism in Patients with Type 2 Diabetes

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  • KANEKO Yukiyo
    Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine (Omori) School of Medicine, Faculty of Medicine, Toho University
  • KUBOKI Koji
    Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine (Omori) School of Medicine, Faculty of Medicine, Toho University
  • HIROI Naoki
    Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine (Omori) School of Medicine, Faculty of Medicine, Toho University
  • WATANABE Takehiko
    Department of Internal Medicine, Makita General Hospital
  • NISHIMURA Chiaki
    Department of Medical Informatics, School of Medicine, Faculty of Medicine, Toho University
  • YOSHINO Gen
    Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine (Omori) School of Medicine, Faculty of Medicine, Toho University

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Objective: The effects of miglitol on postprandial glucose and lipid metabolism were investigated in patients with type 2 diabetes mellitus (T2DM) treated with diet alone. Subjects and Methods: A meal tolerance test (MTT) was performed in 26 diabetic patients before and 2 weeks after 150 mg/day miglitol treatment, with the second MTT performed in patients after they had taken a dose of 50 mg miglitol. Results: Miglitol treatment decreased postprandial blood glucose and serum insulin levels 30 and 60 min after meal loading, but there was no change in blood glucose levels at 120 min. In addition, there were no significant decreases in the area under the curve (AUC) of blood glucose and serum insulin levels. However, the AUC of postprandial serum triglycerides and incremental triglycerides decreased significantly, as did the AUC of postprandial incremental remnant-like particle cholesterol. There were no significant changes in total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol. Conclusions: Miglitol treatment improves postprandial hyperlipidemia, as well as postprandial hyperglycemia, in patients with T2DM. In T2DM patients treated with α-glucosidase inhibitors alone, measuring blood glucose levels 120 min after a meal may not be the best way to monitor postprandial glucose metabolism.

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