Effect of Acarbose on Carbohydrate and Lipid Metabolism in NIDDM Patients Poorly Controlled by Sulfonylureas

Abstract

The ability of acarbose to lower plasma glucose concentration was studied in 12 patients with non-insulin-dependent diabetes mellitus (NIDDM) who were poorly controlled by diet plus sulfonylurea drugs. Patients were studied before and 3 mo after the addition of acarbose to their treatment program, and a significant improvement in glycemic control was noted. Although the decrease in fasting plasma glucose concentration was modest (12.0 +/- 0.8 to 10.8 +/- 0.3 mM), average postprandial plasma glucose concentration decreased by 3.4 mM. When acarbose therapy was discontinued in 5 patients, plasma glucose levels rapidly returned toward pretreatment levels. In addition to the improvement in glycemia, acarbose treatment also led to a significant reduction in HbA1c (7.4 +/- 0.2 to 6.4 +/- 0.2%, P less than 0.01) and triglyceride (2.4 +/- 0.1 to 2.1 +/- 0.1 mM, P less than 0.01) concentrations. Neither the plasma insulin response to meals nor insulin-stimulated glucose uptake improved with acarbose therapy, consistent with the view that acarbose improves glycemic control by delaying glucose absorption. Considerable individual variation was noted in the response to acarbose, and the results in 4 patients were dramatic, with striking reductions in both fasting and postprandial glucose concentrations. The addition of acarbose to patients with NIDDM not well controlled by sulfonylureas appears to have significant clinical benefit.

Effects of consuming foods containing oat β-glucan on blood pressure, carbohydrate metabolism and biomarkers of oxidative stress in men and women with elevated blood pressure

“…Like viscous soluble fibers, these compounds reduce postprandial blood glucose and insulin excursions. Several investigations have reported increased whole-body insulin sensitivity after treatment with an a-glucosidase inhibitor in obese subjects with glucose intolerance (Calle-Pascual et al, 1996;Chiasson et al, 1996;Meneilly et al, 2000), although others have failed to find such an effect (Schnack et al, 1989;Reaven et al, 1990;Jenney et al, 1993).…”

Triglyceride‐rich lipoproteins in non‐insulin‐dependent diabetes mellitus: post‐prandial metabolism and relation to premature atherosclerosis

“…Several studies have reported modest reductions in plasma glucose and HbA 1c concentrations in response to acarbose treatment [220][221][222]. In the post-prandial state, its effect is more pronounced, reducing the 1-h postprandial glucose concentration by approximately 20% [222].…”

α-Lipoic Acid: A Multifunctional Antioxidant That Improves Insulin Sensitivity in Patients with Type 2 Diabetes

“…67,71 Acarbose, an a-glucosidase inhibitor, has also been evaluated for its effect on insulin sensitivity in patients with type 2 diabetes and impaired glucose tolerance, and has yielded conflicting results. [72][73][74][75] It appears that although acarbose does not result in a decrease in insulin resistance, insulin sensitivity probably improves in the long-term as a result of improved metabolic control. Acarbose is currently being evaluated in an international study for its ability to prevent or delay the progression of impaired glucose tolerance to type 2 diabetes.…”