Orien L Tulp*

Professor of Medicine and Graduate Studies, University of Science Arts and Technology, Montserrat, British West Indies, and East West College of Natural Medicine, Sarasota FL, USA

*Corresponding Author: Orien L Tulp, Professor of Medicine and Graduate Studies, University of Science Arts and Technology, Montserrat, British West Indies, and East West College of Natural Medicine, Sarasota FL, USA.

Received: April 08, 2025; Published: May 02, 2025

Abstract

Luminal glucosidase inhibitors and GLP-1 agents (incretins) bring about similar, dose-related improvements in post-prandial glycemic and insulinogenic responses to ingested carbohydrates in man and animals. The metabolic improvements are likely due to the combined physiological effects of both decreasing the rate of gastric emptying and subsequent delays in carbohydrate digestion and luminal glucose uptake, combined with modest decreases in caloric intake with both therapeutic regimens. The combined impact of the above ultimately results in decreases in insulinogenic responses and improved insulin sensitivity in peripheral tissues. Both therapeutic approaches result in an approximate 15% decrease in daily caloric intake and decreases in plasma insulin and improved plasma lipid profiles, in a manner that is somewhat analogous to the consumption of a higher fiber, low glycemic index, and complex carbohydrate diet. While the duration of the GLP-1 approach may prove to be therapeutically effective for only a limited duration often of one year or less, dietary approaches to control caloric intake including glucosidase inhibitors typically may be continued indefinitely and with minimal risk of long-term adverse or rebound effects. Thus, the combination of GLP-1 (incretin) agonists, α-glucosidase inhibitors, and dietary and lifestyle interventions as monotherapy or combined therapy may prove to be useful adjuncts in addressing the global burgeoning problems linked to obesity, T2DM and insulin-resistant states in man and animals.

Keywords: Obesity; Diabetes; GLP-1; Glucosidase Inhibitors; Glycemic Responses

References

1. Kelly T., et al. “Global burden of obesity in 2005 and projections to 2030”. International Journal of Obesity 32 (2008): 1431-1437.
2. Pantalone KM., et al. “Incidence of T2DM: clinical characteristics, complications, comorbidities and treatment patterns among patients with Type 2 diabetes mellitus in a large integrated health system”. BMJ Open Diabetes Research Care 3 (2015): e000093.
3. World Health Organization. “The challenge of obesity in the WHO European region and the strategies for response”. Geneva: World Health Organization (2007).
4. Astrup A. “Reflections on the discovery GLP-1 as a satiety hormone: Implications for obesity therapy and future directions”. European Journal of Clinical Nutrition 78 (2025): 7.
5. Gutzweiller JP., et al. “Glucacon like peptide-1: a potent regulator of food intake in humans”. Gut 1 (1999): 81-86.
6. Holst JJ. “From the incretin concept and the discovery of GLP-1 to today’s diabetes therapy”. Frontiers in Endocrinology 10 (2019): 260.
7. Halder F., et al. “A review of incretin mimetics in the management of diabetes and associated comorbidities” (2024).
8. Tulp OL., et al. “Luminal α-glucosidase inhibition improves insulin sensitivity and modulates glycemic and lipid profiles in obese rats with Type 2 diabetes mellitus”. Global Translational Medicine 13 (2025): 1-13.
9. Tulp OL. “Can inhibitors of luminal carbohydrate digestion decrease insulin resistance in obesity and T2DM?” Journal of Medical, Clinical and Surgical Case Reports 3 (2025): 1-5.
10. Loscalzo J and Harrison TR. “Harrison's Principles of Internal Medicine”. 21^st (2022).
11. Azpiroz F. “Intestinal gas dynamics: mechanisms and clinical relevance”. Gut 7 (2005): 893-895.
12. Wortha SM., et al. “Gastrointestinal Hormones in Healthy Adults: Reliability of Repeated Assessments and Interrelations with Eating Habits and Physical Activity”. Nutrients11 (2021): 3809.
13. Huang HJ., et al. “Hyperamylinemia, hyperinsulinmia, and insulin resistance in genetically obese LA/Ntul//-cp rats”. Hypertension 19 (1992): 101-109.
14. Adeghate E., et al. “Amylin analogs in the treatment of diabetes mellitus: medicinal chemistry and structural basis for its function”. Open Medicinal Chemistry Journal 5 (2012): 78-81.
15. Seino Y., et al. “GIP and GLP-1, the two incretin hormones: similarities and differences”. Journal of Diabetes Investigation 1 (2020): 1-2.
16. Assefa ST., et al. “Alpha glucosidase inhibitory activities of plants with focus on common vegetables”. Plants (Basel) 9 (2019): 2-19.
17. Tulp OL. “Impact of luminal regulation of hepatic enzymes of energy metabolism in the obese and obese-diabetic (T2DM) corpulent rat”. Japanese Journal of Medical Research 2 (2025): 1-7.
18. Tulp OL and Rizvi SAA. “Luminal α-Glucosidase Inhibition Improves Lipid Parameters in Obese T2DM Rats”. Journal of Pharmacology and Experimental Therapeutics3 (2025).
19. Leto D and Saltiel AR. “Regulation of glucose transport by insulin: Traffic control of GLUT4”. Nature Reviews Molecular Cell Biology 13 (2012): 383-396.
20. Tulp OL. “Glucocorticoid Ablation Restores Glycemic and Thermogenic Parameters in Obesity, Chapter in: Cortisol: between Physiology and Pathology, Edited by: Diana Loreta Păun Intech Open (2024).
21. Dimitriadis GH., et al. “Effect of alpha glucosidase inhibition on meal glucose tolerance and timing of insulin administration in patients with Type 1 diabetes mellitus”. Diabetes Care5 (2025): 393-398.
22. Hillman RJ., et al. “Effect of alpha-glucosidase inhibitors on glucose profiles in insulin-dependent diabetes”. Diabetes Research2 (1989): 81-84.
23. Akmal M and Wadhwa R. “Alpha glucosidase inhibitors”. In StatPearls; StatPearls Publishing: Tampa, FL, USA (2022).
24. Zheng MY., et al. “Effects of 24-week treatment with acarbose on glucagon-like peptide 1 in newly diagnosed type 2 diabetic patients: A preliminary report”. Cardiovascular Diabetology 12 (2013): 73.
25. Nagal E., et al. “Effects of miglitol in combination with intensive insulin therapy on blood glucose control with special reference to incretin responses in type 1 diabetes mellitus”. Endocrine Journal10 (2011): 869-877.
26. Haddad F., et al. “A Comprehensive Review on Weight Loss Associated with Anti-Diabetic Medications”. Life4 (2023): 1012.
27. Gao X., et al. “Meta-analysis and critical review on the efficacy and safety of alpha-glucosidase inhibitors in Asian and non-Asian populations”. Journal of Diabetes Investigation 9 (2018): 321–331.
28. Lazzaroni E., et al. “Anti-diabetic drugs and weight loss in patients with type 2 diabetes”. Pharmacology Research 171 (2021): 105782.
29. Bray GA. “Energy and fructose from beverages with sgar or high fructose corn syrup pose a health risk for some people”. Advances in Nutrition 4 (2013): 220-225.
30. Yi S-Y., et al. “Dietary carbohydrate quality is associated with epigenetic age acceleration: a cross -sectional study of the CARDIA cohort”. Journal of Nutrition4 (2025): 1210-1217.
31. Ravussin E., et al. “Plasma ghrelin concentration and energy balance: Overfeeding and negative energy balance studies in twins”. The Journal of Clinical Endocrinology and Metabolism 86 (2002): 4547.
32. Juul A., et al. “Metabolic effects of GH: a rationale for continued GH treatment of GH-deficient adults after cessation of linear growth”. Hormone Research3 (1995): 64–72.
33. Tulp OL., et al. “Effects of Biophotonic Treatment on Hematologic Parameters”. Preprints (2023).

Citation

Citation: Orien L Tulp. “Incretin-Like Glycemic and Metabolic Effects of Luminal Starch Blockers". Acta Scientific Women's Health 7.6 (2025): 02-06.

Copyright

Copyright: © 2025 Orien L Tulp. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.