Voglibose

6,072 views
5,141 views

Published on

Published in: Health & Medicine
0 Comments
4 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
6,072
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
0
Comments
0
Likes
4
Embeds 0
No embeds

No notes for slide

Voglibose

  1. 1. VogliboseAlpha-glucosidase Inhibition
  2. 2. Alpha-glucosidase Inhibitors
  3. 3. Alpha-glucosidase Inhibitors
  4. 4. Alpha-glucosidase Inhibitors α-Glucosidase inhibitors (AGI) are anti- hyperglycemic agents that, by blockade of oligosaccharide catabolism, 1. Delay (in small doses) or 2. inhibit (in larger doses) carbohydrate digestion and absorption, and, thus inhibit/ maintain smooth and lower blood glucose levels after a meal. Current consensus supports their use as monotherapy or adjunct therapy for poorly controlled NIDDM.
  5. 5. Alpha-glucosidase Inhibitors Acarbose Miglitol Acarbose Voglibose Miglitol Voglibose
  6. 6. Alpha-glucosidase Inhibitors Work by preventing the digestion of carbohydrates  Starch, table sugar Carbohydrates normally digest to create simple saccharides  Absorbed in the intestines (small) Mechanism of action includes competitive inhibition of enzymes needed to digest carbohydrates  Reduces rate of digestion of carbohydrates! Long-term effects include a small decrease in hemoglobinA1c levels
  7. 7. 7Alpha-glucosidase Inhibitors Efficacy the enzyme α-glucosidase in the gut  Inhibit  Prevent conversion of complex CHO to simple CHO  Thus, delay the absorption of CHO  Hence, reduced PPBG excursions  Very modest in efficacy, usually take 6-8 weeks Side Effects  Flatulence or abdominal discomfort common  No effect on lipids or blood pressure  No weight gain or loss  Contraindicated in IBD or Cirrhosis
  8. 8. Alpha-glucosidase InhibitorsAcarbose Miglitol & Voglibose  postprandial hyperglycemia   postprandial hyperglycemia Inhibits glycoside hydrolases  Inhibit glycoside hydrolases  glucosidase  Taken at beginning of a meal Taken at beginning of a meal  Miglitol is systemically Gastrointestinal side effects absorbed  Common  Excreted by the kidneys Higher efficacy than Voglibose  Voglibose is newest:  less side effects  economical Miglitol Voglibose Acarbose
  9. 9. Alpha-glucosidase Inhibitors
  10. 10. Alpha-glucosidase Inhibitors
  11. 11. Alpha-glucosidase Inhibitors Indications  Newly diagnosed patients insufficiently treated with diet and dominating postprandial hyperglycemia  Elderly multimorbid patients  Elderly patients with weight gain or hypoglycemia under treatment with insulin secretagogues  Patients with hepatic or renal disorders
  12. 12. Advice to patients on AGIs Start low, go slow Prefer nutrients with complex carbohydrates (rice, pasta, full bread, vegetables, fruits) Avoid refined carbohydrates (sugar, sweets). Take only three meals Avoid laxatives, such as sugar alcohols (sorbitol) Control your postprandial blood glucose to experience the efficacy of treatment In most cases gastrointestinal side-effects are transient
  13. 13. Alpha-glucosidase Inhibitors AGIs have clear beneficial effects on glycemic control and postload insulin levels but not on plasma lipids. In patients with type 2 diabetes, alpha glucosidase inhibitors improve glycaemic control in studies of mainly 24 weeks’ duration. Data are lacking on the effects of alpha glucosidase inhibitors on mortality, diabetes related morbidity, and quality of life.
  14. 14. Therapy algorithm

×