Precose Review Article
Taken alone or with a combination of other diabetic medication like Diabinese, Micronase, Glucophage and Insulin, Precose is an oral medication for type 2 (non insulin dependent) diabetes treatment, its used when high blood sugar levels can not be controlled by diet alone, by slowing down the digestion of carbohydrates after a meal it ensures blood sugar levels don’t surge upwards. Precose is an inhibitor of the alpha glucosidase enzyme, which releases glucose from larger carbohydrates. It is sold under various names, such as Glucobay (Bayer AG) in Europe, Precose (Bayer Pharmaceuticals) in North America, and in Canada as Prandase(Bayer AG).
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Precose is Prescribed for:
It is believed that strict sugar control in diabetics decreases the risk of eye, kidney, and nerve damage. Alpha-glucosidase inhibitors are used to help lower blood sugar levels that are not controlled by diet and exercise. Precose can be used alone to treat type II diabetes or can be combined with sulfonylureas such as glyburide (Diabeta) or metformin (Glucophage) or with insulin. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Mechanism of action:
Preccose inhibits enzymes (glycoside hydrolases) needed to digest carbohydrates: specifically alpha-glucosidase enzymes in the brush border of the small intestines and pancreatic alpha-amylase. Pancreatic alpha-amylase hydrolyzes complex starches to oligosaccharides in the lumen of the small intestine, whereas the membrane-bound intestinal alpha-glucosidases hydrolyze oligosaccharides, trisaccharides, and disaccharides to glucose and other monosaccharides in the small intestine. Inhibition of these enzyme systems reduces the rate of digestion of complex carbohydrates. Less glucose is absorbed because the carbohydrates are not broken down into glucose molecules. In diabetic patients, the short-term effect of these drugs therapies is to decrease current blood glucose levels: the long term effect is a small reduction in HbA1c.
The initial Precose dose may start 25 mg three times daily and then increase after four to eight weeks to 50-100 mg three times daily. Precose should be taken at the first bite of each meal.
Smaller doses may be adequate for patients with severe kidney dysfunction or liver disease. Precose is not recommended if cirrhosis is present. Precose therapy is not advised in the presence of certain medical conditions such as inflammatory bowel disease or intestinal obstruction and chronic intestinal diseases that interfere with digestion or absorption such as Crohn's disease.
Precose doses should be adjusted based upon blood glucose levels taken one hour after a meal and blood HbA1c levels taken about three months after starting or changing the dose. (HbA1c is a chemical in the blood that is a good indicator of blood glucose control.)
Precose may interfere with digoxin absorption thereby decreasing digoxin blood levels and its effect. Therefore, the digoxin dose may need to be increased if Precose is begun. Since adding insulin or a sulfonylurea to Precose therapy may lower blood glucose more than Precose alone, the risk for developing hypoglycemia is greater when these drugs are combined. Caution should be used when combining these drugs. If mild to moderate hypoglycemia occurs while taking Precose in combination with another anti-diabetic agent, the hypoglycemia should be treated with oral glucose (dextrose) instead of sucrose (table sugar) because Precose blocks the digestion of sucrose to glucose, and hypoglycemia will not be corrected rapidly with sucrose. Precose alone does not produce hypoglycemia.
Precose is in the U.S. Food and Drug Administration pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take Precose without first talking to your doctor if you are pregnant or could become pregnant during treatment.
Precose is excreted in the milk of lactating animals, but no human studies have been conducted. Do not take Precose without first talking to your doctor if you are breast-feeding a baby. Precose passes into breast milk and may affect a nursing infant.
Alcohol increases blood sugar; ask your doctor for information on how much is safe to drink.
Possible Side Effects:
The most common side effects with Precose therapy are abdominal pain, diarrhea and flatulence. There is a rare possibility that these gastrointestinal side effects may become severe and progress to paralytic ileus. Other possible but rare side effects are an increase in liver enzymes, and decreases in hematocrit, calcium or vitamin B6 levels.
Precose should be stored at room temperature, 59-86°F (15-30°C) away from moisture and heat in he container it came in, tightly closed, and out of reach of children.
Package Size and Type:
Tablets: 25, 50 and 100 mg.
Caution! Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.
Permitted by the U.S. Food and Drug Administration, Precose drug is a medication that is prescribed to be taken orally for diabetic patients in controlling blood sugar level- especially Type II diabetes (non-insulin dependant). Belonging to a class of drugs known as alpha-glucosidase inhibitors such as miglitol or Glyset, Precose tablets not only help in reducing the levels of blood sugar, but also prevent the risks of other associated health hazards like damage of nerve, kidney and eye. The presence of Alpha-glucosidase inhibitors in the Precose medication helps in lowering sugar levels that cannot be otherwise controlled by exercise and diet. Long-term Precose usage is found to aid in weight loss. Thus, Precose weight loss benefit can also be derived by its constant use. Precose helps in lowering the speed of the activities of alpha-amylase and alpha-glucosidase enzymes so that the increase of high blood sugar after a meal is inhibited.
Precose is also prescribed in combination with certain sulfonylureas like glyburide (Diabeta), metformin (Glucophage) or insulin for treating Type II diabetes. However, combining sulfonylurea or insulin with Precose is found to increase the risk for a condition called Precose hypoglycemia. Precose hypoglycemia should be treated immediately with dextrose or with oral glucose. But, avoid taking sucrose instead of dextrose as it may hinder the process of the digestion of sucrose to glucose.
You can begin the initial dosage of Precose drug 25 mg three times per day and then increase the dosage by 50-100 mg three times per day. Remember to take the Precose medication at the first meal. People who are suffering from liver disease or severe kidney dysfunction should take only smaller Precose dosage. Precose should be avoided by cirrhosis patients and those with chronic intestinal diseases, intestinal obstruction or inflammatory bowel disease. Precose adverse effects include paralytic ileus, diarrhea, abdominal pain, flatulence, liver enzyme increase, and reduction of calcium and hematocrit.
Glucobay (Precose) resume:
Precose has been approved for the treatment of the type 2 diabetic patients for approximately fourteen years. This articles highlights meta-analysis of Precose clinical studies highlighting its clinical efficacy and safety. The efficacy of Precose has been established in more than 3oooo patients. Precose not only reduces the blood glucose levels but also associated with cardio protective action. One of the studies (MeRIA) has shown that treatment with Precose tend to reduce the chances of vascular disease and damage. Clinical reports have shown that Precose reduces post meal hyperglycemia thereby reducing the chances of myocardial infarction. Moreover Precose is not associated with any weight gain which is generally observed with sulphonylureas, glinides or thiazolidinediones. This cardiprotective action of Precose is associated with excellent safety profile. The most common side-effects seen with Precose are mild-to-moderate gastrointestinal (GI) side-effects which subside after a period of one or two weeks.
Conclusion: Precose is the only agent approved for the treatment of prediabetes. The excellent safety, efficacy profile along with cardioprotective action makes Precose a valuable option to treat type II diabetes.
Gene action in prevention of diabetes.
According to study published in Journal of Biological Chemistry scientists have claimed to be very close in finding ways to prevent or cure diabetes. Dr. Chaodong Wu, AgriLife Research nutrition and food scientist had said that a focus on nutrition will find the way to both prevent and reverse diabetes. He further added that the research team will collaborate with nutritionists to identify what changes or supplements in a diet will be require to activate the gene so as to prevent or stop the progression of diabetes.
According to to National Institutes of Health diabetes is a disease in which blood sugar level increases considerably by which the body finds it difficult to convert food into glucose which further gives energy to the body. When the body is not successfully able to metabolize food , glucose starts accumulating in the blood which can lead to serious conditions like heart disease, stroke, kidney disease, blindness, nerve problems and gum infections.
PFKFB3 is the name of gene which is supposed to be the fighting way against diabetes, which is identified as a regulator for metabolism playing an important role in the development of diabetes. Dr. Wu clarified that obesity is not the reason for diabetes, infact it is the inflammation of metabolism which leads to this disease, which is the main reason that researchers are analyzing PFKFB3 as it regulates metabolism. There is a need of nutritionists and biological chemists to work together to design diet plans to prevent developing metabolic inflammation.
Precose more effective in post meal endothelial dysfunction
A study was conducted at Department Of Cardiovascular Medicine, Dokkyo Medical University, Japan to examine the effect of postprandial endothelial dysfunction. The main aim of study was to compare the effect of Precose and nateglinide on postprandial (after meal) endothelial dysfunction. It is strongly believed that excess of sugar level in blood after meal affects the vascular endothelial function.
Thirty subjects were under taken in the study which includes 19 men and 11 women who were newly diagnosed with Type 2 diabetes. The individuals were divided into three different groups. One group received 300 mg of Precose daily, the second group received daily 270 mg of nateglinide and third group received no medication. The subjects were fed cookies which include 75 gm of carbohydrate, 25 gm of butter fat and 7 gm of protein. After given the cookies, insulin and glucose levels were tested at regular intervals of 0, 30, 60 and 120 minute. Along with these levels, endothelial function by flow mediated dilation (FMD %) was also monitored between the duration of 0 to 120 minutes. The study was conducted for 12 weeks. The levels of insulin and glucose were same in all the three groups. While the FMD after meal was significantly improved among the patients who were given Precose. This suggests that intake of Precose refines postprandial endothelial function by improvement of post meal hyperglycaemia as compared to nateglinide.
Type 2 diabetes is the most rapidly growing disease in the present situation. Many scientists and researchers are constantly indulged to develop the treatment for this disease. The latest drugs formulated are based on group of gastrointestinal hormones known as in cretins which increases the amount of insulin released from beta cells after eating. These drugs have benefits of body weight control with no hypoglycaemic attacks. The initial recommendation is to restrict the accumulation of HbAlc and other is to use metformin. There are in total four possible combinations which include Precose, sulfonylureas, glitazones and gliptins. But these combinations must be use without any delay i.e. at 6.5 or 7% HbAlc.
Precose Review Article