Effect of acarbose on biochemical responses and clinical symptoms in dumping syndrome

A dose of 50 mg of acarbose was administered with a standard breakfast to 13 subjects with dumping syndrome. Significant attenuation of hyperglycaemia (p less than 0.01) was observed, and rises in plasma gastric inhibitory polypeptide, insulin and enteroglycagon were reduced (p less than 0.05). Plasma levels of neurotensin, vasoactive intestinal polypeptide and somatostatin were not affected. Dumping score was reduced, but this did not achieve statistical significance. In a longer-term study, 9 patients took acarbose, 50 mg t.i.d., for 1 month. No significant reduction in the number or severity of dumping attacks was observed, but a majority expressed a preference for the drug and some individuals experienced a marked improvement of symptoms.

Effect of long-term treatment with insulin and/or acarbose on glomerular basement membrane thickening in alloxan-diabetic rats

Acarbose is a competitive inhibitor of the intestinal alpha-glycosidases, that can delay absorption of intestinal carbohydrates causing their malabsorption. In the present paper we studied the effects of insulin, acarbose and their association on glomerular basement membrane thickening in alloxan-diabetic rats. Twenty-five male and female Wistar rats, approximately 3 months old at the beginning of the experiment, were assigned randomly to each of five experimental groups: normal control rats, alloxan-diabetic control rats, alloxan-diabetic rats treated with acarbose, alloxan-diabetic rats treated with insulin, and alloxan-diabetic rats treated with insulin plus acarbose. Alloxan was administered in a single iv dose of 42 mg/kg body weight. Insulin was given subcutaneously at doses of 18 to 30 IU/kg corrected daily on the basis of glycosuria and ketonuria. Acarbose was given mixed with rat chow in a dose of 50 mg/100 g chow. Body weight, water and food intake and diuresis, as well as blood and urine glucose were determined after 1, 3, 6, 9, and 12 months of treatment. Glomerular basement membrane (GBM) thickening was determined by electron microscopy at the same times. Clear clinical and laboratory signs of severe diabetes, with blood glucose levels above 200 mg/dl and urine glucose above 3000 mg/dl, were observed in all alloxan-diabetic control rats, in all periods of follow-up, whereas administration of insulin or acarbose reduced the blood glucose levels of treated groups. The most satisfactory control of blood and urine glucose was observed in animals treated with both insulin and acarbose. However, diarrhea was observed in diabetic rats treated with acarbose associated or not with insulin. GBM thickening was correlated with age in all groups. Beginning at six months after diabetes induction, the GBM of untreated diabetic rats was significantly thicker (mean +/- SEM, 4.446 +/- 0.45 mm) than that of normal rats (2.977 +/- 0.63 mm). Both insulin and acarbose prevented GBM thickening and their combination induced thickening similar to the age-dependent thickening observed for normal rats of the same age. We conclude that acarbose when combined with insulin may be a good option in the control of diabetes and its renal complications.

Drugs for diabetes and obesity

14.1 Drugs for diabetes 14.1.1 Diabetes mellitus 14.1.2 Physiology of the pancreas 14.1.3 Insulin replacement therapy 14.1.4 Metformin 14.1.5 Acarbose 14.1.6 Sulfonylureas 14.1.7 Glitazones 14.1.8 Glucagon-like peptide-1, exenatide and sitagliptin 14.2 Drugs for obesity 14.2.1 Introduction 14.2.2 Amphetamine 14.2.3 Phentermine 14.2.5 Orlistat

野桂花的化学成分研究

首次从野桂花（Osmanthus yunnanensis Fr. P. S. Green）地上部分95%乙醇提取物中通过色谱分离得到20个化合物, 其中化合物20为新化合物。基于波谱数据它们被鉴定为(E)-阿魏酸二十烷基酯(1)、β-谷甾醇(2)、羽扇豆醇(3)、齐墩果酸(4)、7-oxo-β-sitosterol(5)、乙酰齐墩果酸(6)、(6′-O-palmitoyl)-sitosterol 3-O-β-D-glucoside(7)、rotundioic acid(8)、地榆糖甙Ⅱ(9)、27-O-(E)-对羟基肉桂酰-28-齐墩果酸(10)、27-O-(Z)-对羟基肉桂酰-28-齐墩果酸(11)、hycandinic acid ester(12)、绿原酸丁酯(13)、4,5-二咖啡酰奎尼酸丁酯(14)、4,5-dihydroxyprenyl caffeate(15)、28-O-β-D-glucopyranosyl rotundioic acid (16)、4-(6-O-caffeoyl-β-D-glucopyranosyloxy)-5-hydroxyprenyl caffeate (aohada-glycoside C, 17)、 4-β-D-glucopyranosyloxy-5-hydroxy-prenyl caffeate (aohada-glycoside A, 18)、β-胡萝卜甙(19)以及3-[O-β-D-(6-O-咖啡酰吡喃葡萄糖)]-甲基-2-烯-γ-内酯 (20)。化合物13、14、15和17有较强的α-葡萄糖甙酶抑制活性。当浓度为1 mg/ml时，它们对α-葡萄糖甙酶的抑制分别为61.5%、95.5%、72.1%、62.6%，活性高于阿卡波糖。 综述了木犀属植物化学成分及1993年以来苯丙素甙类化合物活性研究进展。 Twenty compounds were isolated from the 95% ethanol extract of the aerial parts of Osmanthus yunnanensis Fr. P. S. Green by chromatography for the first time. On the basis of spectral data, they were identified as (E)-ferulic acid eicosyl ester (1), β-sitosterol (2), lupenol (3), oleanolic acid (4), 7-oxo-β-sitosterol (5), acetyloleanolic acid (6), (6′-O-palmitoyl)-sitosterol 3-O-β-D-glucoside (7), rotundioic acid (8), ziyu glycosideⅡ (9), 3β-hydroxy-27-p-(E)-coumaroyloxy-olean-12-en-28-oic acid (10), 3β-hydroxy-27-p-(Z)-coumaroyloxyolean-12-en-28-oic acid (11), hycandinic acid ester (12), chlorogenic acid butyl ester (13), 4,5-di-O-caffeoylquinic acid butyl ester (14), 4,5-dihydroxyprenyl caffeate (15), 28-O-β-D-glucopyranosyl rotundioic acid (16), 4-(6-O-caffeoyl-β-D-glucopyranosyloxy)-5-hydroxyprenyl caffeate (aohada- glycoside C, 17), 4-β-D-glucopyranosyloxy-5-hydroxyprenyl caffeate (aohada- glycoside A, 18), β-daucosterol(19) and 3-[O-β-D-(6-O-caffeoylglucopyranosyl)]- methyl-2-en-γ-lactone (20). Compound 20 is a new one. Compounds 13, 14, 15 and 17 inhibit α-glucosidase with corresponding inhibitory rate of 61.5%, 95.5%, 72.1% and 62.6% at a concentration of 1 mg/ml, higher than acarbose. The chemical studies on Osmanthus genus and bioactivities of phenylpropanoid glycosides were summarized.

Lactobacillus strains isolated from infant faeces possess potent inhibitory activity against intestinal alpha- and beta-glucosidases suggesting anti-diabetic potential

Purpose: Inhibitors of intestinal alpha-glucosidases are used therapeutically to treat type 2 diabetes mellitus. Bacteria such as Actinoplanes sp. naturally produce potent alpha-glucosidase inhibitor compounds, including the most widely available drug acarbose. It is not known whether lactic acid bacteria (LAB) colonising the human gut possess inhibitory potential against glucosidases. Hence, the study was undertaken to screen LABs having inherent alpha- and beta-glucosidase inhibitory potential. Methods: This study isolated, screened, identified and extracted Lactobacillus strains (Lb1–15) from human infant faecal samples determining their inhibitory activity against intestinal maltase, sucrase, lactase and amylase. Lactobacillus reference strains (Ref1–7), a Gram positive control (Ctrl1) and two Gram negative controls (Ctrl2–3), were also analysed to compare activity. Results: Faecal isolates were identified by DNA sequencing, with the majority identified as unique strains of Lactobacillus plantarum. Some strains (L. plantarum, L. fermentum, L. casei and L. rhamnosus) had potent and broad spectrum inhibitory activities (up to 89 %; p < 0.001; 500 mg/ml wet weight) comparable to acarbose (up to 88 %; p < 0.001; 30 mg/ml). Inhibitory activity was concentration-dependent and was freely available in the supernatant, and was not present in other bacterial genera (Bifidobacterium bifidum and Escherichia coli or Salmonella typhimurium). Interestingly, the potency and spectrum of inhibitory activity across strains of a single species (L. plantarum) differed substantially. Some Lactobacillus extracts had broader spectrum activities than acarbose, effectively inhibiting beta-glucosidase activity (lactase) as well as alpha-glucosidase activities (maltase, sucrase and amylase). Anti-diabetic potential was indicated by the fact that oral gavage with a L. rhamnosus extract (1 g/kg) was able to reduce glucose excursions (Area under curve; 22 %; p < 0.05) in rats during a carbohydrate challenge (starch; 2 g/kg). Conclusion: These results definitively demonstrate that Lactobacillus strains present in the human gut have alpha- and beta-glucosidase inhibitory activities and can reduce blood glucose responses in vivo. Although the potential use of LAB such as Lactobacillus as a dietary supplement, medicinal food or biotherapeutic for diabetes is uncertain, such an approach might offer advantages over drug therapies in terms of broader spectrum activities and fewer unpleasant side effects. Further characterisation of this bioactivity is warranted, and chronic studies should be undertaken in appropriate animal models or diabetic subjects.

Effects of chronic treatment with arabose on glucose and lipid metabolism in obese diabetic wistar rats

Aims: The effect of chronic treatment with acarbose on fasting plasma glucose, insulin, triglyceride, cholesterol and free fatty acid (FFA) concentrations, as well as on the glucose and insulin excursions during oral glucose tolerance test (OGTT), in obese diabetic Wistar (WDF) rats was investigated. Methods: Forty-five mature male WDF rats were randomly distributed to one of the three treatment groups (no acarbose, 20 mg and 40 mg of acarbose/100 g of chow, respectively). After 3.5, 7.5 and 11.5 months, animals were tested for glucose tolerance by means of an OGTT, and their respective metabolic profiles were determined. Control determinations were done in obese and age-matched lean animals before the start of the trial. Results: The WDF rats exhibit higher body weight and fasting blood glucose, insulin, triglyceride and cholesterol concentrations compared to lean animals. Moreover, they show marked glucose intolerance as indicated by the glucose and insulin excursions during OGTT. Interestingly, in both treated and untreated animals, a reversion of the hyperglycaemic state as well as an improvement of the glucose tolerance is observed. However, whereas in the group receiving no acarbose this is accounted for by dramatic increases in fasting plasma insulin concentrations and insulin secretion during OGTT (as indicated by the ΔInsulin area), in rats treated with acarbose the reversion of the diabetic state takes place without increments in hormone concentration. In addition, rats treated with acarbose for 3.5 and 7.5 months show lower plasma triglyceride and FFA concentrations, and the same was observed for cholesterol at the highest dosage of the drug. Conclusions: Chronic treatment with acarbose of WDF rats improves the glycaemic and lipidic control as well as the glucose tolerance, with a lower demand of pancreatic insulin than in untreated rats. This data suggests that the long-term modulation of glucose and insulin excursions after meals improves the insulin sensitivity in this rat strain.

Amylase and glucosidase enzyme inhibitory activity of ginger (Zingiber officinale Roscoe) an in vitro study

The prevalence of type 2 diabetes has reached to an epidemic proportion in Sri Lanka. The need for achieving better control of blood glucose level has been evident in diabetes management. However it is not easy to achieve this goal in a large proportion of patients. This is partly due to limitations of currently available pharmacological agents which stimulate research on novel anti-diabetic agents with different mechanisms. Digestive enzymes have been targeted as potential avenues for modulation of blood glucose concentration through inhibition of the enzymatic breakdown of complex carbohydrates to meal derived glucose absorption. Acarbose is a widely used oral anti-diabetic drug which inhibits the α-glucosidase, enzyme responsible for breaking down of disaccharides and polysaccharides into glucose. Many herbal extracts have been found to posses similar inhibitory effects. Ginger (Zingiber officinale Roscoe) has developed a reputation in treatment of several diseases. In vitro enzymic inhibitory effect of ginger was investigated in this study. Enzymes α -amylase and α -glucosidase treated with either Acarbose or ginger extract were allowed to react with cooked rice and percentages of glucose content were measured. The glucosidase and amylase activities on the rice were inhibited by addition of ginger cause significant reduction in glucose percentages (36.86± 1.05 to 26.87± 2.17, P<0.05 and 49.04±0.65 to 35.35±2.22, P<0.05) which showed comparable results with Acarbose on glucosidase activity (36.86± 1.05 to, 27.8±1.32 P<0.05). Results of the study indicates ginger as a potential plant based amylase and glucosidase inhibitor in carbohydrate digestion but usage in glycaemic control in human has to be investigated further.

Reduction of podocytes number in late diabetic alloxan nephropathy: prevention by glycemic control

OBJETIVO: Avaliar o número de podócitos e espessamento da membrana basal glomerular (MBG) em ratos diabéticos com e sem controle glicêmico com 6 e 12 meses da indução. MÉTODOS: 100 ratos Wistar com 200-300g compuseram 6 grupos: Normal (N6, N12 - 25 animais) Diabético (D6,D12 - 25 animais) e diabético tratado com insulina 1,8 a 3,0 U/Kg e acarbose misturada a ração (50g para cada 100g de ração) (DT6 e DT12 - 25 animais). Aloxana foi ministrada via endovenosa na dose de 42mg/Kg. Peso, ingestão hídrica e diurese de 24 horas e glicemia e glicosúria foram determinados antes da inoculação, 7 e 14 dias após e mensalmente. No 14ª dia foi iniciado o tratamento. Três grupos de animais (N6, D6 e DT6) foram sacrificados no 6° mês e três grupos (N12, D12 e DT12), no 12ª mês sendo o tecido renal processado para estudo à microscopia eletrônica. RESULTADOS: A glicemia dos animais DT6 e DT12 diferiram significativamente, dos ratos D6 e D12, e não diferiram dos grupos N6 e N12. O número de podócitos do grupo DT6 não diferiu de N6 e D6 (mediana=11); o número de podócitos de DT12 (mediana=11) diferiu de D12 (mediana=8) e não diferiu de N12 (mediana=11). O espessamento da MBG de D6 (0,18 micrômetros) foi menor que D12 (0,29 micrômetros); de DT6 (0,16 micrômetros) foi menor que D6 (0,18 micrômetros) e de DT12 (0,26 micrômetros) foi menor que D12 (0,29 micrômetros). CONCLUSÃO: O controle da hiperglicemia preveniu o espessamento da MBG na nefropatia diabética aloxânica precoce (6 meses) e tardia (12 meses), e a diminuição do número de podócitos.

Estudo comparativo entre cinco diferentes tratamentos sobre as alterações clínicas e laboratoriais do rato diabético induzido pela aloxana

OBJETIVOS: Este estudo visa a analisar os efeitos, a longo prazo, de cinco diferentes tratamentos sobre o controle metabólico de ratos diabéticos aloxânicos. MÉTODOS: Foram analisados 7 grupos experimentais, com 50 ratos cada um, sendo: GN o grupo controle normal; GD o grupo controle diabético, sem tratamento; GI, GA e GIA os grupos tratados, respectivamente, com insulina, acarbose e associação insulina + acarbose; GTIL o grupo tratado com transplante de ilhotas de Langerhans; e o GTPD o grupo tratado com transplante pancreatoduodenal heterotópico. Parâmetros clínicos (peso, ingestão hídrica, ingestão alimentar e diurese) e laboratoriais (glicemia, glicose urinária e insulina plasmática) foram avaliados em todos os animais, no início do experimento, e após 1, 3, 6, 9 e 12 meses de seguimento. RESULTADOS: À exceção do GN, mortalidade foi observada em todos os grupos experimentais no seguimento de 12 meses (GD= 50%; GI= 20%; GA= 26%; GIA= 18%; GTIL= 4%; GTPD= 20%). em GD, GI, GA e GIA os óbitos ocorreram por distúrbios metabólicos ou hidroeletrolíticos e/ou pneumonia, diarréia e caquexia; em GTIL e GTPD todos os óbitos ocorreram por falhas técnicas no pós-operatório até 72h. Animais dos grupos GI, GA e GIA tiveram melhora significativa (p < 0,05) de todos os parâmetros clínicos e laboratoriais observados em ratos diabéticos, sem diferença de efetividade entre os tratamentos. Porém, os resultados observados nestes grupos, biologicamente não foram comparáveis aos observados em GTIL e GTPD, onde observou-se correção completa, aos níveis normais, de todas as variáveis analisadas (p<0,01). CONCLUSÕES: Os tratamentos convencionais com insulina, acarbose e insulina + acarbose melhoraram o estado diabético grave dos ratos tratados, contudo, a eficácia dos tratamentos foi significativamente inferior à oferecida pelo GTIL e GTPD.

Alterações vasculares na coróide de ratos diabéticos tratados e não tratados

OBJETIVO: Conhecer os efeitos do diabetes e o impacto de seu tratamento medicamentoso em curto e longo prazo sobre os vasos da coróide e membrana de Bruch. MÉTODOS: Foram estudados 30 ratos Wistar, divididos em 3 grupos experimentais: grupo controle (GC), grupo diabético (GD) e grupo diabético tratado (GT), estudados 1 mês (momento M1) e 12 meses (momento M2) após o início do experimento. O diabetes foi induzido por aloxana endovenosa, na dose de 42 mg/kg. O GT foi tratado com hipoglicemiante oral (acarbose) e insulina subcutânea. Após o sacrifício, os olhos foram preparados para exame ao microscópio eletrônico de transmissão, interessando a ultra-estrutura da membrana de Bruch e os vasos da coróide. RESULTADOS: O exame ultra-estrutural da coróide dos ratos diabéticos mostrou depósitos na membrana de Bruch, acúmulo de vesículas, glicogênio e corpos densos no citoplasma das células endoteliais. O grupo mais afetado foi de ratos diabéticos de 12 meses (GDM2). Os animais com menor intensidade de alterações foram os ratos tratados por 12 meses (GTM2). CONCLUSÃO: Os ratos diabéticos desenvolveram alterações degenerativas na membrana de Bruch e vasos da coróide. Estas alterações foram mais evidentes nos animais submetidos à doença crônica, mas também ocorreram agudamente. O tratamento a curto prazo não foi capaz de evitar os processos degenerativos. A longo prazo, o tratamento inibiu a progressão destes processos.

Influence of Different Substrates on the Production of a Mutant Thermostable Glucoamylase in Submerged Fermentation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Role of metabolic control on diabetic nephropathy

OBJETIVO: Os autores relatam a influência do controle metabólico do diabetes, experimentalmente induzido no rato, sobre a nefropatia diabética. Eles observaram o efeito da insulina, da acarbose, um inibidor da glicosidase, e de dois agentes combinados sobre o controle metabólico e o desenvolvimento da expansão mesangial de glomérulos renais, no diabetes induzido pela aloxana no rato. MÉTODOS: Usando 5 grupos de ratos Wistar assim definidos: Normal(N), diabéticos não-tratados (D), diabéticos tratados com acarbose (AD); diabéticos tratados com insulina (ID) e diabéticos tratados com insulina associada à acarbose (IAD) foram avaliados os seguintes parâmetros: peso corporal, ingestão alimentar, ingestão hídrica, diurese, níveis de glicose sanguínea e urinária e as lesões renais: alargamento mesangial e vacuolização de células tubulares, usando contagem semi-quantitativa 1, 3, 6, 9 e 12 meses após a indução do diabetes. RESULTADOS: Houve acentuado aumento da glicemia, dos níveis de glicose na urina, da diurese, da ingestão hídrica e alimentar, e progressiva perda de peso nos ratos diabéticos, enquanto que os ratos diabéticos tratados exibiram melhora significativa destes parâmetros, sendo os ratos tratados com insulina + acarbose os que apresentaram controle metabólico mais satisfatório. Houve um significativo alargamento mesangial nos ratos diabéticos quando comparado ao observado nos ratos normais, desde o 3º até o 12º mês após a indução do diabetes, sendo observada diferença significativa entre os animais tratados com acarbose + insulina e os ratos diabéticos não-tratados. Não houve diferença significativa entre os animais tratados somente com acarbose ou com insulina quando comparados com ratos diabéticos não-tratados. CONCLUSÃO: Os autores discutem os resultados abordando o papel do controle metabólico do diabetes na prevenção da nefropatia diabética.

O RATO COMO MODELO EXPERIMENTAL DO DIABETES - ESTUDO CLINICO-LABORATORIAL

In this study, 90 Wistar rats were used. They were equally divided into three experimental groups - control group (CG), diabetic group (DG) and treated diabetic group (TG). The analyzed parameters were clinical (behavior, activity, general aspect, weight, water ingestion and diuresis) and biochemical (fasting glycemia and urinary glycosis). The diabetes was induced by alloxan and, then, treated with insulin associated to oral hypoglycemic (acarbosis). Observations were made at 5 experimental moments, as it follows: 1, 3, 6, 9, and 12 months after the diabetes induction. The results were submitted to variance analysis, with 5% of significance level. The DG presented lower weight and higher diuresis level than the CG and TG. The water ingestion of the CG was similar to TG. The glycemia levels were higher in DG than in CG, at every experimental moment. The TG, however, presented glycemia similar to the CG, except for the dosages at 3, and 9 months. They urinary glycosis of the DG and TG were similar between themselves, but higher than the one of the CG.