Single Administration of α-Glucosidase Inhibitors on Endothelial Function and Incretin Secretion in Diabetic Patients With Coronary Artery Disease: Juntendo University Trial: Effects of Miglitol on Endothelial Vascular Reactivity in Type 2 Diabetic Patients With Coronary Heart Disease (J-MACH)

• Published in: Circulation Journal 2010, Vol.74(7), pp.1471-1478
• Main Authors: Hiki, Makoto, Shimada, Kazunori, Kiyanagi, Takashi, Fukao, Kosuke, Hirose, Kuniaki, Ohsaka, Hiromichi, Fukushima, Yoshifumi, Kume, Atsumi, Matsumori, Rie, Sumiyoshi, Katsuhiko, Miyazaki, Tetsuro, Ohmura, Hirotoshi, Kurata, Takeshi, Miida, Takashi, Daida, Hiroyuki
• Format: Article
• Language: English
• Subjects: 1-Deoxynojirimycin - administration & dosage; 1-Deoxynojirimycin - analogs & derivatives; Aged; Coronary artery disease; Coronary Artery Disease - drug therapy; Coronary Artery Disease - etiology; Coronary Disease - drug therapy; Coronary Disease - etiology; Cross-Over Studies; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Double-Blind Method; Endothelial function; Endothelium, Vascular - drug effects; Endothelium, Vascular - physiopathology; Enzyme Inhibitors - administration & dosage; Female; Glucose - metabolism; Glycoside Hydrolase Inhibitors; Humans; Hypoglycemic Agents - therapeutic use; Incretin; Incretins - metabolism; Inositol - administration & dosage; Inositol - analogs & derivatives; Lipid Metabolism; Male; Middle Aged; Treatment Outcome; α-Glucosidase inhibitors
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-10-0013

Background: Post-prandial hyperglycemia, hyperlipidemia, and endothelial dysfunction play an important role in the pathogenesis of atherosclerosis. Improvement in post-prandial hyperglycemia on α-glucosidase inhibitors (α-GIs) is associated with a risk reduction of cardiovascular diseases, but the post-prandial effects of α-GIs on endothelial function and incretin secretion in type 2 diabetic patients with coronary artery disease (CAD) remain unclear. Methods and Results: The post-prandial effects of a single administration of miglitol and voglibose on endothelial function and changing levels of glucose, insulin, lipids, glucagon-like peptide (GLP)-1, and gastric inhibitory polypeptide (GIP) were compared after a standard meal loading in 11 diabetic patients with CAD, using a placebo-controlled cross-over design. The changing levels of glucose, insulin and triglycerides at 60 min were significantly lower in the miglitol group than in the voglibose and placebo groups (all P