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

摘要: Background/Objectives: Despite considerable literature supporting the potential health benefits of reducing postprandial glucose (PPG), and insulin (PPI) exposures, size a clinically relevant reduction is currently unknown. We performed a systematic review and meta-analysis to quantify effects alpha-glucosidase inhibiting (AGI) drugs on acute postprandial responses. Methods: searched EMBASE MEDLINE until March 13, 2018 for controlled studies using AGI together with standardized carbohydrate load or mixed meal. The mean incremental levels were calculated as outcomes. Metaanalyses, stratified by diabetes state, using random models. Results: 66 included publications comprised 127 drug-control comparisons PPG, and 106 PPI, mostly testing acarbose miglitol. absolute PPG larger among individuals (-1.5 mmol/l mean [95%CI -1.9, -1.1] acarbose, and -1.6 [-1.9, -1.4] miglitol) compared without (-0.4 -0.5, - 0.3] -0.6 [-0.8, -0.4] miglitol). Relative reductions in both drugs were similar diabetic non-diabetic (43-54%). Acarbose miglitol also significantly reduced relative being largest among individuals diabetes. Conclusions: present meta-analyses provide quantitative estimates PPG and PPI responses non-diabetic individuals. These data can serve benchmarks clinically and PPI via drug diet lifestyle interventions.