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Effects of Alpha-Glucosidase Inhibiting Drugs on Acute Postprandial Glucose and Insulin Responses: a Systematic Review and Meta-Analysis

Alssema, Marjan, Ruijgrok, Carolien, Blaak, Ellen E., Egli, Léonie, Dussort, Pierre, Vinoy, Sophie, Dekker, Jacqueline M. and Robertson, M. Denise (2020) Effects of Alpha-Glucosidase Inhibiting Drugs on Acute Postprandial Glucose and Insulin Responses: a Systematic Review and Meta-Analysis Nutrition and Diabetes.

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Abstract

Background/Objectives: Despite considerable literature supporting the potential health benefits of reducing postprandial glucose (PPG), and insulin (PPI) exposures, the size of a clinically relevant reduction is currently unknown. We performed a systematic review and meta-analysis to quantify effects of alpha-glucosidase inhibiting (AGI) drugs on acute postprandial glucose and insulin responses.

Methods: We searched EMBASE and MEDLINE until March 13, 2018 for controlled studies using AGI drugs together with a standardized carbohydrate load or mixed meal. The mean incremental postprandial glucose and insulin levels were calculated as outcomes. Metaanalyses, stratified by diabetes state, were performed by using random effects models.

Results: The 66 included publications comprised 127 drug-control comparisons for PPG, and 106 for PPI, mostly testing acarbose or miglitol. The absolute effects on PPG were larger among individuals with diabetes (-1.5 mmol/l mean PPG [95%CI -1.9, -1.1] by acarbose, and -1.6 [-1.9, -1.4] by miglitol) as compared to individuals without diabetes (-0.4 [95%CI -0.5, - 0.3] by acarbose, and -0.6 [-0.8, -0.4] by miglitol). Relative reductions in PPG by both drugs were similar for diabetic and non-diabetic individuals (43-54%). Acarbose and miglitol also significantly reduced mean PPI, with absolute and relative reductions being largest among individuals without diabetes.

Conclusions: The present meta-analyses provide quantitative estimates of reductions of PPG and PPI responses by alpha-glucosidase inhibiting drugs in diabetes and non-diabetic individuals. These data can serve as benchmarks for clinically relevant reductions in PPG and PPI via drug or diet and lifestyle interventions.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Alssema, Marjan
Ruijgrok, Carolien
Blaak, Ellen E.
Egli, Léonie
Dussort, Pierre
Vinoy, Sophie
Dekker, Jacqueline M.
Robertson, M. DeniseM.Robertson@surrey.ac.uk
Date : 2020
Copyright Disclaimer : Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Uncontrolled Keywords : Systematic review; Postprandial glucose; Postprandial insulin; Alpha-glucosidase inhibitors; Diabetes
Related URLs :
Depositing User : Clive Harris
Date Deposited : 15 Jun 2020 12:32
Last Modified : 15 Jun 2020 12:32
URI: http://epubs.surrey.ac.uk/id/eprint/857976

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