α‐Glucosidase inhibitors in diabetes: efficacy in NIDDM subjects
α‐Glucosidase inhibitors in diabetes: efficacy in NIDDM subjects
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DOI：
10.1111/j.1365-2362.1994.tb02253.x
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发表时间：
1994-08
影响因子：
5.5
通讯作者：
M. Toeller
中科院分区：
文献类型：
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作者：
M. Toeller
无论阿卡波糖是否与其他口服降糖药联合给药或仅与饮食联合给药，α-葡萄糖苷酶抑制剂通常可改善NIDDM患者的代谢控制。最显著的发现是餐后血糖浓度的降低。长期研究显示，糖化血红蛋白降低，通常空腹血糖水平也降低。安慰剂对照研究已证明，阿卡波糖治疗可降低餐后胰岛素浓度，而空腹血浆胰岛素通常不变。阿卡波糖治疗的主要副作用涉及胃肠道系统，包括肠胃气胀、腹部不适和腹泻。症状随着治疗时间的延长而减轻，并且当以低剂量开始治疗时不太严重。阿卡波糖通常应在每次主要含碳水化合物餐前立即开始服用50 mg剂量。阿卡波糖单药治疗不会引起低血糖，但是，由于众所周知的原因，磺脲类药物或胰岛素联合治疗可能会发生低血糖。在这种情况下，低血糖必须通过服用葡萄糖来治疗。
With α‐glucosidase inhibitors generally improved metabolic control is achieved in NIDDM patients regardless of whether acarbose is administered in addition to other oral anti‐diabetic agents or to diet alone. The most significant finding is the reduction of postprandial blood glucose concentrations. Long‐term studies show a decrease in glycosylated haemoglobin and often also in fasting blood glucose levels. Placebo‐controlled studies have proven that postprandial insulin concentrations are decreased under acarbose treatment while fasting plasma insulin is usually unchanged. The major side‐effects of acarbose treatment involve the gastrointestinal system and include flatulence, abdominal discomfort and diarrhoea. Symptoms diminish with treatment time and are less severe when the treatment is started with low doses. Acarbose should usually be initiated as a 50 mg dose immediately before each major carbohydrate containing meal. Monotherapy with acarbose does not cause hypoglycaemia, however, hypoglycaemia may occur with combination of sulphonylurea or insulin treatment by the well‐known reasons. In this case hypoglycaemia has to be treated by taking glucose.