Aoki Kazutaka, Muraoka Tomonori, Ito Yuzuru, Togashi Yu, Terauchi Yasuo
Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama.
Intern Med. 2010;49(12):1085-7. doi: 10.2169/internalmedicine.49.3218. Epub 2010 Jun 15.
The incidence of the gastrointestinal adverse effects is important to determine as these effects are the reason for lower compliance of alpha-glucosidase inhibitors (alphaGIs). There has been no direct investigation of the adverse effects with acarbose or miglitol, therefore we compared them in healthy subjects.
Twenty-two healthy men were administered 75 mg of miglitol or 100 mg of acarbose per every meal for three days. After four drug-free washout days, they were administered 100 mg of acarbose or 75 mg of miglitol per every meal, respectively. They reported the state of their stool, borborygmi, abdominal bloating, flatus, and abdominal pain on the 1st and 3rd day.
Stool tended to be soft when miglitol was administered and to be firm when acarbose was administered. The flatus score of acarbose was greater than that of miglitol. The abdominal bloating score of acarbose was greater than that of miglitol on the 1st day.
Our results suggest that if diabetic patients have constipation, firm stool, or flatus they may be administered miglitol and if they have diarrhea or soft stool they may be administered acarbose.
确定胃肠道不良反应的发生率很重要,因为这些反应是α-葡萄糖苷酶抑制剂(αGIs)依从性较低的原因。此前尚未对阿卡波糖或米格列醇的不良反应进行直接研究,因此我们在健康受试者中对它们进行了比较。
22名健康男性连续三天每餐服用75毫克米格列醇或100毫克阿卡波糖。经过四个无药洗脱期后,他们分别改为每餐服用100毫克阿卡波糖或75毫克米格列醇。他们在第1天和第3天报告了自己的大便情况、肠鸣音、腹胀、肠胃气胀和腹痛情况。
服用米格列醇时大便往往偏软,服用阿卡波糖时大便往往偏硬。阿卡波糖的肠胃气胀评分高于米格列醇。第1天,阿卡波糖的腹胀评分高于米格列醇。
我们的结果表明,如果糖尿病患者有便秘、大便干结或肠胃气胀,可能适合服用米格列醇;如果有腹泻或大便偏软,则可能适合服用阿卡波糖。