Comparison of Acarbose and Voglibose in Diabetes Patients Who Are Inadequately Controlled with Basal Insulin Treatment: Randomized, Parallel, Open-Label, Active-Controlled Study

Abstract

We studied the efficacy and safety of acarbose in comparison with voglibose in type 2 diabetes patients whose blood glucose levels were inadequately controlled with basal insulin alone or in combination with metformin (or a sulfonylurea). This study was a 24-week prospective, open-label, randomized, active-controlled multi-center study. Participants were randomized to receive either acarbose (n=59, 300 mg/day) or voglibose (n=62, 0.9 mg/day). The mean HbA1c at week 24 was significantly decreased approximately 0.7% from baseline in both acarbose (from 8.43% ± 0.71% to 7.71% ± 0.93%) and voglibose groups (from 8.38% ± 0.73% to 7.68% ± 0.94%). The mean fasting plasma glucose level and self-monitoring of blood glucose data from 1 hr before and after each meal were significantly decreased at week 24 in comparison to baseline in both groups. The levels 1 hr after dinner at week 24 were significantly decreased in the acarbose group (from 233.54 ± 69.38 to 176.80 ± 46.63 mg/dL) compared with the voglibose group (from 224.18 ± 70.07 to 193.01 ± 55.39 mg/dL). In conclusion, both acarbose and voglibose are efficacious and safe in patients with type 2 diabetes who are inadequately controlled with basal insulin. (ClinicalTrials.gov number, NCT00970528)

Improving postprandial hyperglycemia in patients with type 2 diabetes already on basal insulin therapy: Review of current strategies

“…Both acarbose and voglibose resulted in similar significant reductions in HbA1c (from a mean [±s.d.] 8.43 ± 0.71% to 7.71 ± 0.93% and from 8.38 ± 0.73% to 7.68 ± 0.94%, respectively) in patients inadequately controlled on basal insulin, with a greater reduction in PPG with acarbose (from 233.54 ± 69.38 to 176.80 ± 46.63 mg/dL and from 224.18 ± 70.07 to 193.01 ± 55.39 mg/dL, respectively) . Similar effects on PPG compared with nateglinide were reported in patients with optimal FPG on basal insulin .…”

“…Both acarbose and voglibose resulted in similar significant reductions in HbA1c (from a mean [AEs. 107 Similar effects on PPG compared with nateglinide were reported in patients with optimal FPG on basal insulin. 108 However, acarbose was less effective in terms of HbA1c reduction than either rosiglitazone or metformin when added to insulin monotherapy (−0.6% vs −2.4% and −2.0%, respectively), with comparable improvements in FPG and PPG levels.…”

Machine learning prediction for mortality of patients diagnosed with COVID-19: a nationwide Korean cohort study

“…Loop diuretics are recommended to be considered in patients with congestive heart failure or advanced chronic renal disease 19 . Alpha-glucosidase inhibitors including acarbose are often used with a basal insulin regimen when basal insulin treatment alone did not result in glycemic control, especially postprandial glucose level in Asians 20 . Thus, the poor outcome in the patients taking the medications may have been due to the fact that they had have a longer duration of more comorbidities, not due to the direct drug effects.…”

Comparisons of Effects on Intestinal Short-Chain Fatty Acid Concentration after Exposure of Two Glycosidase Inhibitors in Mice

“…As first-line hypoglycemic drugs used in patients with type 2 diabetes especially in Asian since their diet meals contain high content of carbohydrates, acarbose and voglibose can typically reduce postprandial glucose level by delaying carbohydrate digestion in the gut, so they can be a useful treatment in the patients who raised basal glucose concentrations slightly and marked postprandial hyperglycemia. 2) In addition, there will also be some side effects, mainly reflected in gastrointestinal flatulence, loose stool and so on. The main reason for this is that fermentation of undigested carbohydrates by bacteria produced gas in the colon.…”