Effect of miglitol (BAY m-1099) on fasting blood glucose in type 2 diabetes mellitus.

Background: In type 2 diabetes mellitus, fasting blood glucose values are increased due to increased glycogenolysis and gluconeogenesis. As miglitol (BAY m-1099), an absorbable alpha-glucosidase inhibitor, can inhibit glycogenolysis, we investigated whether 200 mg miglitol ingested at bedtime could decrease fasting blood glucose values.

Methods: Twelve type 2 diabetic patients participated in a double-blind, randomised, placebo-controlled, cross-over study. The study duration was 6 weeks: 2 weeks run-in, 2 test periods of 1 week with 2 weeks of wash-out in between. During run-in and wash-out periods placebo tablets were used. Fasting blood glucose (FBG), insulin (FIRI), C-peptide (FCP), glucagon (FG), pyruvate and alanine were measured at the start of the study, at the end of the run-in and wash-out periods, and at the 6th and 7th day of each test period.

Results: Both during miglitol and placebo no effects on FBG (12.2 +/- 2.5 vs. 12.2 +/- 2.5 mmol/l), FIRI (80 +/- 34 vs. 82 +/- 35 pmol/l), FCP (1110 +/- 303 vs. 1043 +/- 304 pmol/l), FG (20 +/- 13 vs. 20 +/- 10 pmol/l), pyruvate (101 +/- 28 vs. 112 +/- 30 mumol/l) or alanine (440 +/- 87 vs. 465 +/- 133 mumol/l) were observed.

Conclusions: Miglitol 200 mg taken at bedtime for 1 week has no influence on hepatic glucose production.