The effects of miglitol and metformin on vitamin status in Type 2 diabetes

摘要

Anti-diabetic drugs such as miglitol and metformin have been shown to effectively reduce postprandial glucose levels in patients with Type 2 diabetes. The potential side effects of these drugs on vitamin status have not been considered. The objectives of this study were to determine the biochemical status of a select group of vitamins, including A, B1, B12 , and folate, in Type 2 diabetes patients, and to determine if the status of these vitamins is affected by anti-diabetic drugs. A total of 324 patients from across Canada participated in this 48-week double-blind, placebo controlled study. Subjects were randomized into one of 4 treatment groups: placebo, miglitol, metformin, or the combination of miglitol and metformin. The diabetic patients were found to be at risk of deficiency of vitamins A, B1, B 12, and folate. Plasma levels of vitamins A and B12 were significantly decreased (p < 0.05) in the metformin treated group, while vitamin B1 was significantly (p < 0.05) decreased in the combination treatment group. No significant effects were observed in the miglitol treated group. These results suggest that Type 2 diabetes patients treated with metformin only may require vitamin A and B12 supplementations. Miglitol may be the agent of choice, either alone or as an adjuvant to oral anti-diabetic therapy, since it has not been shown to adversely affect the biochemical status of the vitamins studied.