Effects of changeover from voglibose to acarbose on postprandial triglycerides in type 2 diabetes mellitus patients

• Published in: Advances in therapy 2009-06, Vol.26 (6), p.660-666
• Main Authors: Matsumura, Mihoko, Monden, Tsuyoshi, Miyashita, Yasushi, Kawagoe, Yoshiaki, Shimizu, Hiroaki, Nakatani, Yuki, Domeki, Nozomi, Yanagi, Kazunori, Ikeda, Shiori, Kasai, Kikuo
• Format: Article
• Language: English
• Subjects: Acarbose - therapeutic use; Aged; Blood Glucose - analysis; Cardiology; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Endocrinology; Enzyme Inhibitors - therapeutic use; Female; Glycoside Hydrolase Inhibitors; Health technology assessment; Humans; Hypoglycemic Agents - therapeutic use; Inositol - analogs & derivatives; Inositol - therapeutic use; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Research; Pharmacology/Toxicology; Rheumatology; Triglycerides - blood
• ISSN: 0741-238X; 1865-8652
• DOI: 10.1007/s12325-009-0040-7

Introduction In this study, we examined the effects of the α-glucosidase inhibitors acarbose and voglibose on postprandial plasma glucose and serum triglyceride levels in patients with type 2 diabetes mellitus. Methods Twenty-one Japanese patients with type 2 diabetes were enrolled in this study. Subjects had been treated with voglibose for at least 3 months. They underwent a 400 kcal balanced food meal tolerance test before and 8 weeks after the changeover from voglibose to acarbose. Subjects were divided into two groups: the first group (low-dose group; n =11) was changed over from 0.6 mg/day voglibose to 150 mg/day acarbose, and the other (high-dose group; n =10) from 0.9 mg/day voglibose to 300 mg/day acarbose. Results The increment rate of postprandial plasma glucose ([plasma glucose 2 hours after test meal - fasting glucose]/fasting glucose) decreased from 34.7%±23.9% to 25.0%±24.6% ( P =0.13) in the low-dose group, and decreased significantly from 56.1%±53.1% to 31.5%±36.0% ( P =0.03) in the high-dose group after changeover. However, there were no significant changes in blood glycated hemoglobin (HbA 1c ) levels before and after changeover in either group. The increment rate of postprandial serum triglyceride (TG) ([serum TG 2 hours after test meal - fasting TG]/fasting TG) decreased significantly only in the high-dose group (52.4%±60.0% to 24.3%±16.6%) ( P =0.05). No significant changes in serum high-density lipoprotein cholesterol levels were observed in either group, whereas serum low-density lipoprotein cholesterol levels decreased significantly from 3.20±0.25 to 2.65±0.18 mmol/L ( P =0.04), only in the highdose group. Conclusions In patients with type 2 diabetes our findings suggest that acarbose 300 mg/day is superior to voglibose 0.9 mg/day in improving postprandial hyperglycemia and hypertriglyceridemia.