Effect of two new alpha-glucosidase inhibitors in insulin-dependent diabetic patients

The delay in glucose absorption at the intestinal level obtained with the administration of alpha-glucosidase inhibitors may contribute to an improved metabolic control in diabetic patients. We have examined the effects of two new compounds, BAY m 1099 (short acting) and BAY o 1248 (long acting), on the postprandial glycemic changes, the insulin requirements and the meal-induced hormone responses in nine insulin-dependent diabetics (IDD). The investigation was conducted according to a protocol in which medication and placebo were administered in a double-blind randomized manner. Twelve hours before each experimental day, the patients were connected to the Biostator GCIIS (Ames-Miles) to maintain stabilized normoglycemic levels for the whole period of study. The results showed that: (1) BAY m 1099 decreased the 4-h postprandial glycemic excursions compared to placebo both at dinner and breakfast (P less than 0.05), (2) BAY o 1248 when compared with placebo showed a significant lowering of the peak glycemic levels at breakfast (P less than 0.001) and at lunch (P less than 0.0025), (3) the 2-h and 4-h post-breakfast insulin requirements fell significantly after either drug (P less than 0.02), (4) the plasma levels of contrainsular hormones were not affected by drugs or placebo at any time during the period of study, and (5) no side effects with either drug could be detected. We conclude from our study that both drugs may be useful adjuncts to insulin therapy in insulin-dependent diabetics by reducing postprandial glycemic fluctuations as well as by decreasing insulin requirements with no modification of the meal-induced hormone responses.