Efficacy of acarbose in different geographical regions of the world: analysis of a real‐life database

Weng, Jianping; Soegondo, Sidartawan; Schnell, Oliver; Sheu, Wayne Huey‐Herng; Grzeszczak, W; Watada, Hirotaka; Yamamoto, Norio; Kalra, Sanjay

doi:10.1002/dmrr.2576

Cited by 35 publications

(26 citation statements)

References 56 publications

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“…Furthermore, although the SGLT2 inhibitors dapagliflozin, canagliflozin and empagliflozin do not increase the risk of hypoglycaemia, there is evidence that they increase the risk of hypovolemic side‐effects and that their glycaemic efficacy is diminished in moderate‐to‐severe renal impairment . In addition, alpha glucosidase inhibitors are not generally recommended for people with renal impairment due to potential accumulation and lack of safety information …”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of lixisenatide in patients with type 2 diabetes and renal impairment

Hanefeld¹,

Arteaga

Leiter

et al. 2017

Diabetes Obesity Metabolism

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AimsThis post hoc assessment evaluated the efficacy and safety of once‐daily, prandial glucagon‐like peptide‐1 receptor agonist lixisenatide in patients with type 2 diabetes (T2D) and normal renal function (estimated glomerular filtration rate ≥90 mL/min), or mild (60‐89 mL/min) or moderate (30‐59 mL/min) renal impairment.MethodsPatients from 9 lixisenatide trials in the GetGoal clinical trial programme were categorized by baseline creatinine clearance: normal renal function (lixisenatide n = 2094, placebo n = 1150); renal impairment (mild: lixisenatide n = 637, placebo n = 414; moderate: lixisenatide n = 122, placebo n = 68). Meta‐analyses of placebo‐adjusted mean differences between baseline renal categories were performed for efficacy and safety outcomes.Results HbA1c, 2‐hour postprandial plasma glucose and fasting plasma glucose were comparably reduced in lixisenatide‐treated patients with normal renal function, and mild and moderate renal impairment. The most common adverse events (AEs) in all renal function categories were gastrointestinal (GI), predominantly nausea and vomiting. A 14% higher incidence of GI AEs and a 10% higher incidence of nausea and vomiting were seen with mild impairment vs normal function (P = .003 for both), but no significant differences were observed between the mild and moderate impairment categories (P = .99 and P = .57, respectively), or between the moderate impairment and normal categories (P = .16 and P = .65, respectively). Additionally, the incidence of hypoglycaemia was similar in all categories.ConclusionsThis study demonstrates that baseline renal status does not affect efficacy outcomes in lixisenatide‐ vs placebo‐treated patients, and that no lixisenatide dose adjustment is required for patients with T2D with mild or moderate renal impairment.

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Section: Discussionmentioning

confidence: 99%

“…28 In addition, alpha glucosidase inhibitors are not generally recommended for people with renal impairment because of potential accumulation and lack of safety information. 28,29 The ADA/EASD treatment guidelines have designated GLP-1…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of lixisenatide in patients with type 2 diabetes and renal impairment

Hanefeld¹,

Arteaga

Leiter

et al. 2017

Diabetes Obesity Metabolism

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“…To date, there are no evidences to suggest different treatment strategies for LADA in Asian and European people. However, it is hypothesised that due to differences in ethnicity, lifestyle, and eating habits, efficacy of any particular treatment in LADA may differ between 2 populations in a similar way as in Asian DM2 patients in whom incretin‐based therapies and alpha‐glucosidase inhibitors show better efficacy than in Caucasians …”

Section: Treatment Strategiesmentioning

confidence: 97%

“…However, it is hypothesised that due to differences in ethnicity, lifestyle, and eating habits, efficacy of any particular treatment in LADA may differ between 2 populations in a similar way as in Asian DM2 patients in whom incretin-based therapies and alpha-glucosidase inhibitors show better efficacy than in Caucasians. 104,105 A pilot trial using rosiglitazone plus insulin in Chinese Asians showed preserved β-cell function as compared to Insulin alone. 106 Interestingly, Chinese herb extract tripterygium an oral immunosuppressive agent maintained stimulated C-peptide levels in Chinese LADA subjects.…”

Section: Differencesmentioning

confidence: 99%

Latent autoimmune diabetes in adults (LADA) in Asian and European populations

Kumar

Leiva

2017

Diabetes Metabolism Res

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Diabetes mellitus is a chronic disorder caused by relative or absolute insulin deficiency and characterized by chronic hyperglycaemia. It is expected that by year 2025, 80% of all type 2 diabetic patients will be living in developing or low- and middle-income countries. Among Asians, there has been an overall increase in abdominal obesity; however, the risk of diabetes in these populations starts at much lower body mass index as compared to Caucasians. A significant proportion of diabetic patients with adult-onset, initially nonrequiring insulin treatment, have diabetes-associated autoantibodies in their sera. A new subclass of diabetes with the designation of latent autoimmune diabetes of adult-onset (LADA) has been proposed for this category of subjects. Studies have demonstrated that patients with autoimmune diabetes, characterized by the presence of glutamic decarboxylase autoantibodies display a different clinical phenotype from classical type 2 diabetes without glutamic decarboxylase autoantibodies. This subset of phenotypic type 2 diabetes subjects with islet autoantibodies tend to have sulphonylurea failure and need insulin treatment earlier in the disease process. Diagnosing LADA at an initial stage will be important so that insulin can be initiated earlier, facilitating improved glycemic control sooner as well as the preservation of residual beta-cell function in adult-onset autoimmune diabetes. Because of differences in dietary habits, environmental factors, and phenotypic characteristics between European and Asian populations, there may be heterogeneity in the prevalence and other characteristics of LADA in these two populations.

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“…The effects of both drugs in reducing HbA1c were similar regardless of the patients' body mass index (BMI) 12 . Because certain populations may respond more favorably to either acarbose 13 or metformin, the present post-hoc analysis was undertaken to identify the characteristics of participants in the MARCH trial at baseline and in the treatment period that may be associated with greater efficacy in achieving a HbA1c level <7% (<53 mmol/mol). These J U S T A C C E P T E D results may help inform treatment decisions with respect to initiation of antidiabetic treatment, offering a patient-centered approach to the management of type 2 diabetes 2 .…”

Section: Introductionmentioning

confidence: 99%

Factors that influence the efficacy of acarbose and metformin as initial therapy in Chinese patients with newly diagnosed type 2 diabetes: a subanalysis of the MARCH trial

Zhang

Wang

Yang

et al. 2016

Current Medical Research and Opinion

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Newly diagnosed type 2 diabetes patients with lower baseline 2hPPG and HOMA-IR values are more likely to achieve glucose control with acarbose or metformin treatment. Furthermore, the change in BMI after acarbose or metformin treatment is also a factor influencing HbA1c normalization. A prospective study with a larger sample size is necessary to confirm our results as well as measure β cell function and examine the influence of the patients' dietary habits.

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Efficacy of acarbose in different geographical regions of the world: analysis of a real‐life database

Cited by 35 publications

References 56 publications

Efficacy and safety of lixisenatide in patients with type 2 diabetes and renal impairment

Efficacy and safety of lixisenatide in patients with type 2 diabetes and renal impairment

Latent autoimmune diabetes in adults (LADA) in Asian and European populations

Factors that influence the efficacy of acarbose and metformin as initial therapy in Chinese patients with newly diagnosed type 2 diabetes: a subanalysis of the MARCH trial

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