Comparison of three α-glucosidase inhibitors for glycemic control and bodyweight reduction in Japanese patients with obese type 2 diabetes

Aims/Introduction-Glucosidase inhibitors (GIs) are widely used for the primary treatment of type2 diabetes. We compared the clinical effects of three GIs (miglitol, acarbose and voglibose) in patients with obese type2 diabetes. Materials and MethodsJapanese patients (n=81) with obese type2 diabetes (body mass index [BMI] 25kg/m(2)) were enrolled in this multicenter, open-label study. The participants were randomized into the miglitol (n=18), acarbose (n=22), voglibose (n=19) or control (n=22) groups. Glycemic control (fasting blood glucose and glycated hemoglobin [HbA1c]), bodyweight, BMI, serum insulin, serum lipids (low-density lipoprotein and high-density lipoprotein cholesterol, and triacylglycerols) and adipocytokines (leptin and adiponectin) were evaluated every 4weeks for 12weeks. ResultsIn the miglitol group, HbA1c was improved significantly from the baseline at all points. The changes in HbA1c at 8 and 12weeks from baseline were greater in the miglitol group than the control group. The voglibose group showed significant improvements in HbA1c at 12weeks. Bodyweight and BMI were decreased significantly in the miglitol group. In addition, significant correlations were observed between the decrements in HbA1c and bodyweights over 12weeks in the miglitol (r=0.759, P<0.001) and voglibose groups (r=0.667, P=0.002). Serum lipid and adipocytokine levels were not altered in any groups. ConclusionsGIs, especially miglitol, can effectively control blood glucose and bodyweight in obese type2 diabetes. This study was registered with UMIN (no. UMIN000006465).