Improvement in Blood Glucose Fluctuations in Type 2 Diabetes Mellitus by Voglibose with or without High Fiber Dietary Intervention

DOI: 10.21276/sjams.2017.5.9.35 Abstract: Diabetes Mellitus (DM) is a chronic metabolic disorder affecting people worldwide, with significant morbidity and mortality caused by its micro-vascular and macro-vascular complications, affecting various vital organs and structures in humans. Glycemic variability seems to have more deleterious effects than sustained hyperglycemia on the development of diabetic complications. The aim of the present study was to investigate the effectiveness of voglibose with or without high-fiber dietary intervention for 12 weeks on glycaemic variability in type 2 diabetes patients using a continuous glucose-monitoring system (CGMS).This randomized control trial was conducted at Department of General Medicine of a tertiary care centre. Fifty diagnosed T2 DM patients whose HbA1c levels ranged from 7.0% to 10.0% were randomized to voglibose monotherapy and other 50 patients were randomized to receive voglibose in combination of high-fiber dietary intervention therapy. After 12 weeks intervention, overall glycaemic control and blood glucose variability were evaluated by CGMS parameters. Combination therapy using high-fiber dietary intervention and voglibose was more effective in reducing HbA1c and the mean of daily differences (MODD) than voglibose monotherapy (P < 0.05), whereas no significant differences were found in the mean amplitude of glycemic excursion (MAGE) and largest amplitude of glycemic ezcursions (LAGE) between the combination therapy group and the monotherapy group (P > 0.05).In conclusion, voglibose alone or in combination with high-fiber dietary intervention can improve overall blood glucose levels and glycaemic variability. But voglibose with high-fiber dietary intervention contributes to the alleviation of glycemic variability via modulating intestinal secretion of GLP-1.