Miglitol Insulin

Other combination options Metformin or a Sulfonylurea plus Acarbose/Miglitol, or Pioglitazone/ Rosiglitazone or Repaglinide (with metformin), or Insulin... 

In contrast to sulfonylureas and thiazolidinediones, miglitol does not enhance insulin secretion. Miglitol has minor inhibitory activity against lactase and, at recommended doses, would not be expected to induce lactose intolerance. 

In 33 patients with type 2 diabetes treated with sulfo-nylureas and insulin who took miglitol 50 mg bd for 1 week and then over the next month increased the dose to 50 mg tds, 15% developed adverse effects (6% diarrhea, 6% abdominal distension), which disappeared within 3 weeks of continuing therapy (42). 

Mitrakou A, Tountas N, Raptis AE, Bauer RJ, Schulz H, Raptis SA. Long-term effectiveness of a new alpha-glucosidase inhibitor (BAY ml099—miglitol) in insulin-treated type 2 diabetes mellitus. Diabet Med 1998 15(8) 657-60. 

Other combination options Metfomin or a sulfonylurea plus pioglitazone/rosiglitazone or acarbose/miglitol Metfomin plus Nateglinide or repaglinide or insulin or insulin analog (as mono—or combination therapy) ... 

Another azasugar that has been used for diabetes treatment is miglitol (3) (6). Like acarbose (l)and voglibose (2), it is an oral a-glucosidase inhibitor for use in the management of non-insulin-dependent diabetes mel-litus. Structurally, miglitol (3) is a des-oxynojirimycin derivative, and this family of... 

Miglitol is an alpha-glucosidase inhibitor that inhibits intestinal enzymes that digest carbohydrates, thereby reducing carbohydrate digestion after meals, which lowers postprandial glucose elevation in diabetics. It is used in patients with non-insulin-dependent diabetes mellitus (NIDDM) who have failed dietary therapy. It may be used alone or in combination with sulfonylureas. 

The pharmacokinetic changes seen are minor and unlikely to be clinically relevant. The manufacturers say that while alpha glucosidase inhibitors such as acarbose and miglitol do not cause hypoglycaemia when given alone, they may increase the blood glucose-lowering effects of insulin and... 

Tolbutamide 500 mg two or three times daily was given to 17 patients taking phenytoin 100 to 400 mg daily. The patients had a transient 45% rise in the amount of non-protein-bound phenytoin by day 2, which had disappeared by day 4. The introduction to this report briefly mentions a man given phenytoin and tolazamide who developed phenytoin toxicity, which disappeared when the tolazamide was replaced by insulin. A woman previously uneventfully treated with phenytoin and tolbutamide developed toxicity on a later occasion when she took tolbutamide with twice the previous dose of phenytoin. One study in healthy subjects found that miglitol 100 mg three times daily for 5 days did not affect the bioavailability of a single 400-mg dose of phenytoin. ... 

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