Published online Sep 15, 2000. doi: 10.3748/wjg.v6.iSuppl3.144
Revised: June 19, 2000
Accepted: July 26, 2000
Published online: September 15, 2000
AIM: The control of diet regimen and nutrient intake, aiming to avoid the evaggerated levels of glucose and anabolic hormone is broadly accepted as basic treatment of diabetes mellitus. Maltose is an important hydrolysate of starch, main source of nutrition. Acarbose is an alpha-D-glucosidase inhibitor but with a short inhibitory duration. Gymnemic acid (GA), a group of triterpene glucuronides, inhibits glucose absorption with a longer effective duration but it needs a longer time to achieve its maximum effect. To determine whether nutrient control in diabetic care can be improved by combination of them, we compared the combinative and individual effect of acarbose and GA on maltose absorption and hydrolysis in small intestine.
METHODS: The absorption and hydrolysis of maltose were studied by re-cyclic perfusion of intestinal loops in situ and motility of the intestine was recorded with the intestinal loop in vitro, of Wistar rat.
RESULTS: The total inhibitory rate of maltose absorption was improved by the combination of GA (0.1-1.0 mg/mL) and acarbose (0.1-2.0 mmol/L) throughout their effective duration (P < 0.05, U test of Mann-Whitney), although the improvement only could be seen in the low dosages during the first hour. With the combination, inhibitory duration of acarbose on maltose absorption was prolonged to 3 h and the onset of GA inhibitory effect was fastened to 15 min. GA suppressed the intestinal mobility with a good correlation (r = 0.98) to the inhibitory effect of GA on maltose absorption and the inhibitory effect of 2 mmol/L (higher dose) acarbose on maltose hydrolysis was dual modulated by 1 mg/mL GA in vivo indicating that the combined effects involved the functional alteration of intestinal barriers.
CONCLUSION: There are augmented effects of acarbose and GA, which involve pre-cellular and paracellular barriers. Furthermore, diabetic care can be improved by employing this combination.