Therapeutic Potentials of Acarbose as First-Line Drug in NIDDM Insufficiently Treated With Diet Alone

• Markolf Hanefeld

  Department of Metabolic Diseases and Endocrinology, Lipid Research Unit, Clinic of Internal Medicine, and Institute of Clinical Chemistry and Laboratory Diagnostics, Medical Academy “Carl GustavCarus” Dresden; and Bayer AC, Pharma Research Center Wuppertal, Germany

• Sabine Fischer

  Department of Metabolic Diseases and Endocrinology, Lipid Research Unit, Clinic of Internal Medicine, and Institute of Clinical Chemistry and Laboratory Diagnostics, Medical Academy “Carl GustavCarus” Dresden; and Bayer AC, Pharma Research Center Wuppertal, Germany

• Jan Schulze

  Department of Metabolic Diseases and Endocrinology, Lipid Research Unit, Clinic of Internal Medicine, and Institute of Clinical Chemistry and Laboratory Diagnostics, Medical Academy “Carl GustavCarus” Dresden; and Bayer AC, Pharma Research Center Wuppertal, Germany

• Manfred Spengler

  Department of Metabolic Diseases and Endocrinology, Lipid Research Unit, Clinic of Internal Medicine, and Institute of Clinical Chemistry and Laboratory Diagnostics, Medical Academy “Carl GustavCarus” Dresden; and Bayer AC, Pharma Research Center Wuppertal, Germany

• Manfred Wargenau

  Department of Metabolic Diseases and Endocrinology, Lipid Research Unit, Clinic of Internal Medicine, and Institute of Clinical Chemistry and Laboratory Diagnostics, Medical Academy “Carl GustavCarus” Dresden; and Bayer AC, Pharma Research Center Wuppertal, Germany

• Karl Schollberg

  Department of Metabolic Diseases and Endocrinology, Lipid Research Unit, Clinic of Internal Medicine, and Institute of Clinical Chemistry and Laboratory Diagnostics, Medical Academy “Carl GustavCarus” Dresden; and Bayer AC, Pharma Research Center Wuppertal, Germany

• Katja Fücker

  Department of Metabolic Diseases and Endocrinology, Lipid Research Unit, Clinic of Internal Medicine, and Institute of Clinical Chemistry and Laboratory Diagnostics, Medical Academy “Carl GustavCarus” Dresden; and Bayer AC, Pharma Research Center Wuppertal, Germany

抄録

Acarbose inhibits α-glucosidases of the small intestine and thus delays glucose release from complex carbohydrates. Therefore, its efficacy and acceptability as a first-line drug in non-insulin-dependent diabetes mellitus (NIDDM) insufficiently treated with diet alone was tested in a randomized double-blind placebo-controlled study. Ninety-four NIDDM subjects, aged 43–70 yr with average body mass index of 28 kg/m2 and undergoing a pretreatment period of at least 3 mo with diet alone, were treated with 100 mg acarbose three times daily or placebo for 24 wk. The patients were recruited after a 4-wk screening period of dietary reinforcement. The inclusion limits for patients termed diet not satisfactory were fasting blood glucose (FBG) ≥ 7.8 mM and/or postprandial blood glucose (BG) ≥ 10 mM. FBG was lowered in the acarbose group from 9.8 to 8.4 mM and in the placebo group from 10.2 to 9.6 mM after 24 wk (P = 0.007 vs. placebo). The most impressive therapeutic effect was a highly significant reduction of postprandial hyperglycemia for at least 5 h after the test meal (1-h postprandial BG with acarbose 10.4 mM and placebo 13.5 mM at 24 wk, P < 0.001) accompanied by a significant decrease in HbA1 (acarbose 8.65%, placebo 9.32%, P = 0.003). Whereas C-peptide and fasting serum insulin were not significantly affected by acarbose, postprandial insulin increment was ∼ 30% lower after 24 wk compared with placebo. Furthermore, acarbose significantly reduced 1-h postprandial triglyceride levels. After an initial phase of > 4 wk (when 76.6% in the acarbose group vs. 28% on placebo complained about flatulence, P < 0.001), the drug was well accepted. At the end of the study, only 32% showed mild or moderate gastrointestinal sensations. Extrapolation shows that acarbose is an efficient and acceptable drug for the treatment of NIDDM with poor metabolic control by diet alone. It has beneficial effects on postprandial hyperinsulinemia and postprandial hypertriglyceridemia.

収録刊行物

• Diabetes Care

  Diabetes Care 14 (8), 732-737, 1991-08-01

  American Diabetes Association

キーワード

• Advanced and Specialized Nursing
• Endocrinology, Diabetes and Metabolism
• Internal Medicine

詳細情報

• CRID: 1362825893674743424
• NII論文ID: 30026278667
• NII書誌ID: AA00160920
• DOI: 10.2337/diacare.14.8.732
• ISSN: 19355548
• ISSN: 01495992
• ISSN: http://id.crossref.org/issn/01495992
• Web Site: https://diabetesjournals.org/care/article-pdf/14/8/732/341411/14-8-732.pdf
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