Repeated postprandial hyperglycemia may play an important role in the development of atherosclerosis by suppressing vascular endothelial function. Although miglitol suppresses the elevation of blood glucose levels shortly after a meal more than other α-glucosidase inhibitors, the effect of 3-month repeated administration of miglitol on endothelial dysfunction is unknown. Fifty patients with type 2 diabetes and coronary artery disease were enrolled in the present study. The patients were randomly divided into 2 groups, the first treated with miglitol and the second with voglibose for 3 months. Blood chemistry (lipid and blood glucose profiles, glycosylated hemoglobin, 1,5-anhydroglucitol, serum insulin levels, and C-reactive protein) and flow-mediated dilatation were measured at the beginning and end of the trial period. Patient characteristics and blood chemistry of the 2 groups were similar at the beginning of the trial. At the end of the trial, glycosylated hemoglobin decreased in the 2 groups, but the improvements in 1,5-anhydroglucitol in the miglitol group were significantly higher than in the voglibose group. Insulin resistance index, C-reactive protein, and percentage flow-mediated dilatation were also improved in the miglitol group but not in the voglibose group. In conclusion, 3-month repeated administration of miglitol improved vascular endothelial dysfunction by strongly suppressing postprandial hyperglycemia. Miglitol may have antiatherogenic effects in patients with type 2 diabetes and coronary artery disease.
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