The effects of sucrose meal on insulin requirement in IDDM and its modulation by acarbose

The purpose of the present study was to evaluate the insulin requirement in response to sucrose meal in IDDM and its modulation by a disaccharidase inhibitor, Acarbose. After an overnight fast, the subjects (n = 9) were "hooked" to the artificial pancreas (Biostator) to maintain normoglycemia. Blood glucose and insulin requirement were recorded by the Biostator throughout the experiment. The patients were divided into two groups. In group I, five patients received increasing sucrose load (50, 75 and 100 g) with and without Acarbose 100 mg. After a 50 g sucrose meal with and without Acarbose, the peak postprandial (PP) blood glucose was 118 and 157 mg/dl and the insulin requirement was 3.9 and 7.8 units resulting in free plasma insulin peak of 34 and 59 microU/ml respectively. After a 75 g sucrose meal with and without Acarbose, the peak PC blood glucose was 134 and 166 mg/dl and the insulin requirement was 5.7 and 9.9 units resulting in free plasma insulin peak of 75 and 87 microU/ml. After a 100 g sucrose meal with and without Acarbose the peak PP blood glucose was 131 and 175 mg/dl and the insulin requirement was 6 and 12.8 units resulting in free plasma insulin peak of 50 and 69 microU/ml. In group II, four patients received increasing Acarbose dose with a fixed sucrose load (75 g). The PP blood glucose peaked at 161, 145, 120 and 102 mg/dl after 0, 50, 100, 200 mg of Acarbose respectively. The total insulin requirements were 12.9, 9.6, 4.3 and 3.1 units. The free plasma insulin was decreased by Acarbose treatment while plasma glucagon remained unaffected.(ABSTRACT TRUNCATED AT 250 WORDS)