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Anti-Hyperglycemic Property Of Medicinal Plants
Published in Amit Baran Sharangi, K. V. Peter, Medicinal Plants, 2023
Karanpreet Singh Bhatia, Arpita Roy, Navneeta Bhardavaj
Metformin is a hypoglycemic agent which has the property to reduce plasma glucose levels by inhibiting hepatic gluconeogenesis. It also able to reduce sugar absorption in intestine and LDL and VLDL level reduction with HDL level enhancement was seen in patients treated with metformin for 4–6 weeks. Side effect of this drug includes reduction in cardiovascular mortality, decreased appetite, decrease in pH of blood due to lactate build up (lactose acidosis) especially in patients suffering from congestive heart failure. Pioglitazone is another drug which binds to receptor, i.e., PPAR-γ and enhances insulin sensitivity of hepatocytes, adipocytes, and skeletal muscle cells. After administration of this drug, hyperglycemia reduction, declinement of HbA1c and triglycerides levels occurs with increase in HDL levels. Side effects include hepatotoxicity that may be deadly. Miglitol is another drug which helps in delaying carbohydrate metabolism in the body. It inhibits glucosidase enzyme which is present in the intestinal brush borders that mediate carbohydrates digestion. Side effects include flatulence, diarrhea, and cramps. Glimipride enhances insulin binding capacity to target cells and reduces secretion of glucagon. Side effects include hyperinsulinemia, weight gain, and hypoglycemia (Chcipa et al., 2019). Due to these problems associated with synthetic drugs an alternative to treat diabetes is required. Medicinal plants contain various phytochemical which can be utilized for the treatment of this disease.
Allopathic Medicines
Published in Varma H. Rambaran, Nalini K. Singh, Alternative Medicines for Diabetes Management, 2023
Varma H. Rambaran, Nalini K. Singh
Clinical trials conducted with the dosages of 50–100 mg of miglitol, three times a day in patients with T2DM have shown significant improvements in glycaemic control during a 6 to 12 month period (Scott and Spencer 2000, Campbell, Baker and Campbell 2000). Also, studies have shown that miglitol has a similar efficacy to that of acarbose (but at lower doses), and compared to sulfonylureas, miglitol provides a similar reduction in FBG and postprandial plasma glucose (PPG) levels (Kingma et al. 1992, Scott and Spencer 2000). As a common shortcoming however, both acarbose and miglitol have been reported to cause flatulence, abdominal pain, and diarrhoea.
Role of Natural Agents in the Management of Diabetes
Published in Rohit Dutt, Anil K. Sharma, Raj K. Keservani, Vandana Garg, Promising Drug Molecules of Natural Origin, 2020
Monika Elżbieta Jach, Anna Serefko
Miglitol, as an oral antihyperglycemic agent in the T2DM treatment, is pseudo monosaccharide α-glucosidase inhibitor, which makes improvements to glycemic control. It lessens the levels of FPG, PPG and HbA1c. Miglitol is usually well-tolerated and is not correlated with body weight gain or hypoglycemia when it is taken as monotherapy. The substance is absorbed systemically, however, it is not metabolized and is fast excreted by kidneys. Clinical studies with miglitol (predominately 50 or 100 mg, 3 times a day) in T2DM patients revealed a significant amelioration in glycemic control for periods of 6 to 12 months. In the comparative studies, lower miglitol therapeutic dose had comparable efficacy to a higher acarbose dose (50 and 100 mg, 3 times a day, respectively). In turn, in combination with insulin therapy or other oral antidiabetic substances, miglitol intensified glycemic control in individuals whose metabolic control was suboptimal despite the use of diet and concomitant medications. Most adverse reactions after miglitol uptake are involved in disturbances of the gastrointestinal tract such as abdominal pain, diarrhea, and flatulence. These complaints are generally dependent on the miglitol dose, mild to moderate in intensity, initially transpire and diminish with time. Attenuation of side effects is resolved quickly on miglitol discontinuation or dosage adjustment. Miglitol also proved no significant influence on cardiovascular, renal, respiratory, or hematological function in long term studies (Scott and Spencer, 2000).
Considerations when using alpha-glucosidase inhibitors in the treatment of type 2 diabetes
Published in Expert Opinion on Pharmacotherapy, 2019
Maka S. Hedrington, Stephen N. Davis
AGIs are administered orally with ‘first bite of major meals’ usually three times daily (can be started once daily and titrated to three times). Initial recommended dose for acarbose and miglitol is 25 mg and for voglibose – 0.2 mg per administration with increase in dose every four to 8 weeks based on PPG, glycosylated hemoglobin and tolerance of the drug. Maximum adult dose for acarbose and miglitol is 100 mg and for voglibose – 0.6 mg three times daily [5]. Safety and efficacy of these medications have been shown to be similar in geriatric and younger adults. Very limited data are available in pediatric populations. Acarbose is pregnancy category B (No evidence of risk in studies); AGIs are not recommended during breastfeeding. The drugs are safe to use in mild to moderate but are not in severe renal impairment. No dosage adjustments of AGIs are necessary in individuals with hepatic impairment.