Combined use of basal insulin analog and acarbose reduces postprandial glucose in patients with uncontrolled type 2 diabetes

Abstract

Aims/IntroductionEarly initiation of basal insulin therapy is recommended for normalizing fasting blood glucose in type 2 diabetes mellitus. However, basal insulin treatment might not adequately control postprandial glucose levels. The present study evaluated whether the combination of the α-glucosidase inhibitor, acarbose, and basal insulin improved blood glucose control under daily-life treatment conditions in a large sample of Korean patients.Materials and MethodsThe present study was a multicenter, prospective, observational study under daily-life treatment conditions. A total of 539 patients with type 2 diabetes who were treated with basal insulin and additional acarbose were enrolled and followed up for 20 weeks. Changes in hemoglobin A1c, fasting and postprandial blood glucose were evaluated at baseline and at the end of the observation period. The physician and patient satisfaction of the combination treatment and safety were assessed.ResultsHemoglobin A1c decreased by 0.55 ± 1.05% from baseline (P < 0.0001). Fasting and postprandial blood glucose levels were reduced by 0.89 ± 3.79 and 2.59 ± 4.77 mmol/L (both P < 0.0001). The most frequently reported adverse drug reactions were flatulence (0.37%) and abnormal gastrointestinal sounds (0.37%), and all were mild in intensity and transient. In the satisfaction evaluation, 79.0% of physicians and 77.3% of patients were ‘very satisfied’ or ‘satisfied’ with the combined basal insulin and acarbose therapy.ConclusionsCombination therapy of basal insulin and acarbose in patients with type 2 diabetes improved glucose control, and had no drug-specific safety concerns, suggesting that the treatment might benefit individuals who cannot control blood glucose with basal insulin alone.

Comparison of insulin intensification strategies with insulin lispro low mixture twice daily versus basal insulin glargine and prandial insulin lispro once daily in East Asian and Caucasian patients with type 2 diabetes mellitus

“…[22][23][24] Therefore, even though the study was not powered to assess potential differences between treatment arms in ethnic subgroups, if the numbers of patients were higher it is possible that statistically significant differences between treatment arms may have been evident in one or both subpopulations. Although the number of EA patients was small, the baseline clinical characteristics in this study were similar to those in other clinical trials conducted in EA patients.…”

“…Although the number of EA patients was small, the baseline clinical characteristics in this study were similar to those in other clinical trials conducted in EA patients. [22][23][24] Therefore, even though the study was not powered to assess potential differences between treatment arms in ethnic subgroups, if the numbers of patients were higher it is possible that statistically significant differences between treatment arms may have been evident in one or both subpopulations. Further, each country has varied clinical practice guidelines, prescribing practices, and dietary habits, which have the potential to cause bias in the analysis.…”

Xanthones as potential α‐glucosidase non‐competition inhibitors: Synthesis, inhibitory activities, and in silico studies

“…They are all α ‐glucosidase competitive inhibitors. Most of the competitive inhibitors are glucose analogs, which are not absorbed in the intestine and then easily cause gastrointestinal discomfort through the fermentation of microorganisms (Kim et al, 2015; Kojima et al, 2010). Therefore, the development of safer and more effective α ‐glucosidase non‐competitive inhibitors is of great significance for the treatment of diabetes and related diseases.…”

Identification and Isolation of α-Glucosidase Inhibitors from Siraitia grosvenorii Roots Using Bio-Affinity Ultrafiltration and Comprehensive Chromatography

“…To date, α-glucosidase inhibitors, such as acarbose, miglitol, and voglibose, have been recommended as first-line therapies [ 3 ]. However, these drugs may cause adverse reactions, such as nausea, vomiting, diarrhea, and damage to liver and kidney function [ 4 , 5 ]. Hence, the extraction of effective α-glucosidase inhibitors with low toxicity from medicinal and homologous plants has attracted increasing attention because of their wide range of sources, minimal side effects, and excellent health-promoting activities [ 6 , 7 , 8 ].…”