Therapeutic Research

Abstract

Miglitol, an α-glucosidase inhibitor(α-GI), is useful for controlling the early postprandial elevation of blood glucose, and can be administered in combination not only with other oral hypoglycemic agents but also with insulin preparations. We investigated the effectiveness of combination therapy with miglitol and insulin on Japanese type 2 diabetic patients. Subjects receiving any insulin therapy, including intensive insulin therapy(n=43), mixed insulin therapy(n=22), and basal supported oral therapy(BOT)(n=24) were additionally treated with miglitol for 12 weeks. The HbA1c(NGSP)was significantly lowered from 8.0±1.0% to 7.7 ±1.1%(p<0.01). We evaluated the daily glucose profile by self-monitoring blood glucose(SMBG)at seven points before and after miglitol treatment. Although there was little change in plasma glucose levels before each meal, those at 1 hr after each meal were significantly lowered. Mean AUC0-1hr of postprandial glucose and M-value were also significantly lowered, suggesting that additional treatment with miglitol improved the daily glucose excursion. When subjects were divided into three groups by the types of insulin therapy, similar improvements in the daily glucose excursion were shown in any group. Body weight and daily dosage of insulin were unchanged from the start of miglitol treatment. We conclude that the combination therapy with miglitol and broad types of insulin therapy is effective for reducing the daily glycemic fluctuation and achieving a much better control.