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Mutations of the hepatocyte nuclear factor (HNF)-1[Alpha] gene cause impaired insulin secretion and hyperglycemia in patients with maturity-onset diabetes of the young (MODY)3. Whether these mutations also affect glucose metabolism [...]

Drugs that inhibit carbohydrate metabolism may be beneficial in normalizing plasma glucose and insulin levels, following a high-carbohydrate meal, in patients with non-insulin-dependent diabetes mellitus (NIDDM). The drug trestatin interferes with carbohydrate metabolism by inhibiting pancreatic alpha-amylase, an enzyme that breaks down carbohydrates and thereby allows for their absorption. The effect of trestatin on plasma glucose levels following a meal (postprandial glucose) was determined in six patients with NIDDM and six healthy volunteers. Trestatin was incorporated into bread at doses of 3 milligrams (mg) or 6 mg per 75 grams of starch. Both doses of trestatin reduced peak plasma levels of glucose and reduced insulin secretion in the control group and in patients with NIDDM. Trestatin did not alter the taste, texture or appearance of the bread, was not altered by the baking process, and did not produce any unwanted side effects such as the diarrhea caused by alpha-glucosidase inhibitors (other inhibitors of carbohydrate metabolism). It is concluded that trestatin, incorporated into bread, reduces postprandial blood levels of glucose and insulin in patients with NIDDM. Because the method caused no side effects, did not alter the taste of the food, and was effective, the authors conclude that trestatin incorporated into starchy foods has much potential as a means of treating patients with NIDDM. (Consumer Summary produced by Reliance Medical Information, Inc.)