posted 11/06/02
Miglitol decreased hunger and increased feelings of satiety
after a meal in obese, diabetic patients
Which resulted in a lower caloric intake for
those patients, according to researchers in the U.S. and Australia.
"Previous studies reported that administration of
first generation alpha-glucosidase inhibitors (AGIs), such as voglibose or
acarbose, produced exaggerated and sustained postprandial responses of glucagon-like
peptide-1 (GLP-1), an incretin hormone from the enteroinsular axis, in healthy
humans," said Adrian Lee and colleagues at St. Louis University Medical Center
in the U. S. and the University of Adelaide in Australia.
They added, "Any agent that substantially
elevates GLP-1 levels may theoretically reduce hunger, increase satiation and
limit food intake. This study was performed to analyze the effect of miglitol, a
more potent second generation AGI with fewer gastrointestinal side-effects, on
the regulation of meal-related GLP-1 secretion and on the change of
insulin-glucose dynamics as well as the release of gastric inhibitory
polypeptide (GIP), another incretin hormone, after stimulation by an ordinary
meal in obese type-2-diabetic subjects."
The investigators randomly assigned 8 obese women
with type 2 diabetes to receive either miglitol (100 mg) or placebo 3 times
daily for 2 days. The amount of food consumed was determined by calorie intake
at lunch. On the third day of the study, the researchers measured levels of
GLP-1, GIP, insulin, and glucose within 3 hours after the subjects consumed a
720-kcal breakfast (The effects of miglitol on glucagon-like peptide-1 secretion
and appetite sensations in obese type 2 diabetics. Diabetes, Obesity, and
Metabolism, , 2002;4(5):329-335).
Postprandial GIP release was suppressed and GLP-1
production was enhanced in the patients who received miglitol. GLP-1 levels were
two times greater in miglitol patients compared with the control patients and
reached a maximum concentration 120 minutes after a meal.
Six of the eight subjects whose GLP-1 levels rose
more than 30% from placebo-treated levels consumed 12% fewer calories (p<0.05)
compared with placebo. Patients who received miglitol also reported lower levels
of hunger and greater feelings of satiety than did patients who received
placebo.
"Miglitol induced an enhanced and prolonged GLP-1
release at high physiological concentrations after ingesting an ordinary meal in
glycemic-controlled diabetics," concluded Lee and associates. "The excessive
postprandial GLP-1 elevation after miglitol therapy modified feeding behavior
and food intake, and thereby has potential value in regulating appetite and
stabilizing body weight in obese type-2-diabetic patients."
Key points reported in this study include:
* The alpha-glucosidase inhibitor, miglitol,
decreased postprandial gastric inhibitory polypeptide (GIP) and increased
postprandial glucagon-like peptide-1 (GLP-1) release in obese patients with type
2 diabetes compared with subjects who received a placebo
* Miglitol decreased appetite and increased
feelings of satiety in obese, type 2 diabetic subjects compared with subjects
who received placebo
* Obese, type 2 diabetic
subjects who received miglitol consumed significantly fewer calories than did
subjects who received placebo This article was prepared by Diabetes Week editors
from staff and other reports.
Source: Diabetes In Control Dot Com.
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