Acarbose scientific update |
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Soft skulls in babies due to vitamin D deficiency
Based on the studies conducted so far, the softening of the skull bones is a common problem which is seen in normal-looking newborns. Usually, the babies become alright after a period without any treatment. According to the Japanese scientists, this condition named craniotabes can be a sign of vitamin D deficiency.
The researchers from Kyoto University Hospital found that craniotabes present in some of the infants may disappear after a week. The chance to have this condition is very less in babies born in born at sunnier times of the year. It is suggested to have sun exposure during pregnancy to avoid this problem for the newborn babies.
Researches prove that 7 percent of the babies of one month age will have low vitamin D level. They found that most of the breast-fed babies had less storage form of vitamin D when compared to the babies who received a vitamin D-supplemented formula.
Based on the report submitted online in the Journal of Clinical Endocrinology & Metabolism, it is clear that vitamin D deficiency may lead to skeletal problems, diabetes and colon cancer.
Nuts – a perfect choice for health
Nuts were not an important factor in health related matters because of its fat content. Nowadays nuts are considered as the best health food. Nuts contain constructive ingredients which can improve health such as fiber, protein, calcium, vitamin E, magnesium, potassium, zinc, selenium, copper and arginine. Arginine, an amino acid which is present in nuts, has the power to improve blood-vessel function.
Based on the researches conducted recently, nuts have the capability to reduce the risk of heart attack and type 2 diabetes. It also reduces the need for gallbladder surgery. You can maintain the blood cholesterol levels by taking nuts regularly. Nuts maintain the blood cholesterol level either by displacing harmful foods or by lowering cholesterol directly.
If you are using one ounce of nuts (about 180 calories) regularly, you have to reduce similar calories from your diet. One ounce of nuts is equal to 23 almonds, 6-8 Brazil nuts, 18 cashews (oil roasted), 21 hazelnuts, 10-12 macadamia nuts, 28 peanuts (oil roasted), 19 pecan halves, 167 pine nuts, 49 pistachios and 14 walnut halves.
Diabet Med. 2007 Mar 22;
Wachters-Hagedoorn RE, Priebe
Department of Paediatrics and Department of Medical Biomics, University of Groningen Medical Centre, Groningen, the Netherlands.
Low-dose acarbose does not delay digestion of starch but reduces its bioavailability
Digestion of starch will not be interrupted due to the usage of low-dose acarbose, but bioavailability shall be reduced.
Aims Slowly digestible starch is associated with beneficial health effects. The glucose-lowering drug acarbose has
the potential to retard starch digestion since it inhibits alpha-amylase and alpha-glucosidases. We tested the
hypothesis that a low dose of acarbose delays the rate of digestion of rapidly digestible starch without reducing
its bioavailability and thereby increasing resistant starch flux into the colon. Methods In a crossover study,
seven healthy males ingested corn pasta (50.3 g dry weight), naturally enriched with (13)C, with and without 12.5
mg acarbose. Plasma glucose and insulin concentrations, and (13)CO(2) and hydrogen excretion in breath were
monitored for 6 h after ingestion of the test meals. Using a primed continuous infusion of D-[6,6-(2)H(2)] glucose,
the rate of appearance of starch-derived glucose was estimated, reflecting intestinal glucose absorption. Results
Areas under the 2-h postprandial curves of plasma glucose and insulin concentrations were significantly decreased
by acarbose (-58.1 +/- 8.2% and -72.7 +/- 7.4%, respectively). Acarbose reduced the overall 6-h appearance of
exogenous glucose (bioavailability) by 22 +/- 7% (mean +/-se) and the 6-h cumulative (13)CO(2) excretion by 30 +/-
6%. Conclusions These data show that in healthy volunteers a low dose of 12.5 mg acarbose decreases the appearance
of starch-derived glucose substantially. Reduced bioavailability seems to contribute to this decrease to a greater
extent than delay of digestion. This implies that the treatment effect of acarbose could in part be ascribed to the
metabolic effects of colonic starch fermentation.
Fertil Steril. 2007 Apr 5
Penna IA, Canella PR, Vieira CS, Silva de Sa MF, Reis RM, Ferriani RA.
Obstetrics and Gynecology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil; Gynecology Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Cardiovascular risk factors are reduced with a low dose of acarbose in obese patients with polycystic ovary syndrome.
Low dose of acarbose reduces the cardiovascular risk factors in obese patients with polycystic ovary syndrome.
Polycystic ovary syndrome (PCOS) is defined by menstrual irregularity, hyperandrogenism, chronic anovulation, and
enlarged ovaries with multiple follicles. Polycystic ovary syndrome is highly prevalent in women, affecting up to
10% of all women of reproductive age and reducing the possibility of spontaneous conception. In addition to
altering reproductive function, PCOS has systemic implications, especially in the cardiovascular system.
Cardiovascular risk (CVR) in PCOS patient increases because of insulin resistance, elevated androgen levels, and
association with obesity. Those alterations promote cardiovascular risk factors, such as endothelial dysfunction,
elevated homocysteine levels, left ventricular hypertrophy, and reduced high-density lipoprotein (HDL) cholesterol
(1).
Orv Hetil. 2006 Aug 6;147(31):1443-6.
Simon K, Dobo E, Nadasy T, Retih I, Racz I.
Varosi Korhaz-Rendelointezet, Belgyogyaszati Osztaly, Siofok.
The most effective approach in reduction of cardiovascular risk in type 2 diabetes mellitus?
Find out the most effective ways to reduce cardiovascular risk in type 2 diabetes mellitus patients.
It is well known that the target blood glucose values are not fulfilled in treatment of patients with type 2 diabetes mellitus. (UKPDS) The high mortality rate in type 2 diabetes mellitus is associated with the augmented cardiovascular risk. It is well documented, that the beneficial influence of high blood pressure, dyslipidaemia, and hypercoagulation compared to hyperglycaemia, is a more powerful approach in reduction of cardiovascular risk in type 2 diabetes mellitus. The effect of medical interventions on alteration of cardiovascular risk and glucose homeostasis is not always concordant: betablockers mandatorily reduce cardiovascular risk, but may result in deterioration of blood glucose values, sulfanylurea drugs effectively reduce hyperglycaemia, but could paradoxically increase the cardiovascular risk. The acarbose, methformin, thiazolidindione, fibric acid treatment improves the profile of vascular risk factors, additionally could have a beneficial metabolic effect resulting in reducing cardiovascular risk in patients with type 2 diabetes mellitus. In conclusion: the cardiovascular risk in type 2 diabetes mellitus can be most effectively influenced by reduction of high blood pressure, dyslipidaemia, and dysfunction of haemostasis. The improvement of glucose homeostasis is, novel medical interventions seem to be important tools in reducing cardiovascular risk in patients with type 2 diabetes mellitus.
Diabetes Metab. 2002 Jun;28(3):195-200.
Delgado H, Lehmann T, Bobbioni-Harsch E, Ybarra J, Golay A.
Division of Therapeutic Education for Chronic Diseases, University Hospital Geneva, Switzerland.
Acarbose improves indirectly both insulin resistance and secretion in obese type 2 diabetic patients.
Insulin resistance and secretion will be improved indirectly by acarbose in obese type 2 diabetic patients. BACKGROUND: Acarbose is an oral antidiabetic mainly acting on postprandial blood glucose, inhibiting alphaglucosidase. Through this mechanism, it could improve the peripheral insulin sensitivity and/or increase the insulin secretion. The aim of the present study is to assess the therapeutic efficacy of Acarbose in obese type 2 diabetic patients on both insulin resistance and insulin secretion. METHODS: 17 obese non insulin-dependent diabetic patients, well controlled with diet alone were randomized into 2 groups: acarbose (2 x 50 mg) or placebo during 16 weeks. A glucagon test allowed to evaluate insulin secretion before and after treatment as well as a triple test (glucose-insulin-somatostatin) with indirect calorimetry allowed to evaluate insulin sensitivity. RESULTS: A significant improvement in post-prandial plasma glucose was detected only in the Acarbose group (8.0 +/- 0.5 mmol/l before vs 6.5 0.5 mmol/l after, p<0.05). Basal C-peptide secretion was similar between groups and remained unchanged after treatment. However, stimulated insulin secretion was significantly increased by 30%, p<0.05, in the Acarbose group while no change was detected in the placebo group. Interestingly, the group receiving Acarbose disclosed a 15% reduction in insulin resistance (15.0 +/- 1.8 mmol/l before vs 12.8 +/- 1.4 mmol/l after). CONCLUSIONS: Our results show that a treatment with Acarbose is efficient even in diabetic patients presenting a good glucose control without any other associated treatment. By decreasing post-prandial blood glucose, acarbose improves both insulin sensitivity and secretion.
Clin Ther. 1997 Jul-Aug;19(4):720-9.
Kageyama S, Nakamichi N, Sekino H, Nakano S.
Division of Clinical Pharmacology and Therapeutics, Jikei University School of Medicine, Tokyo, Japan.
Comparison of the effects of acarbose and voglibose in healthy subjects.
Compare the effects of acarbose and voglibose in health related matters. Compare the effects of acarbose and voglibose in health related matters. Acarbose and voglibose are alpha-glucosidase inhibitors. Although the pharmacologic effects and incidence of abdominal adverse events associated with the two drugs have been reported to differ, no study has directly compared acarbose and voglibose. To compare the pharmacologic effects and gastrointestinal adverse events associated with the two drugs, a randomized, placebo-controlled, double-masked, fivefold crossover study was performed in 20 healthy male subjects. To assess the pharmacologic effects, plasma immunoreactive insulin (IRI), plasma glucose, and 24-hour urinary connecting-peptide immunoreactivity (CPR) excretion were measured. Although the postprandial increase in plasma glucose level was reduced significantly with both acarbose and voglibose, the rate of reduction was small. The maximum concentration (Cmax) and area under the plasma concentration-time curve (AUC) of plasma IRI after meals decreased significantly with all treatments except voglibose 0.3 mg compared with placebo. Overall, the Cmax and AUC of plasma IRI decreased more when subjects received acarbose than voglibose. Urinary CPR excretion decreased by 30.6% and 41.7%, respectively, in subjects who received acarbose 50 mg or 100 mg compared with the previous day when no drug was given, whereas the urinary CPR excretion did not decrease significantly with voglibose. There was no significant difference in the frequency of gastrointestinal adverse events between groups, including the placebo group. One-day administration of acarbose and voglibose at currently recommended clinical doses demonstrated that acarbose was more effective in sparing endogenous insulin secretion than was voglibose.
Med Klin. 1998 Nov 15;93(11):651-5.
Herrmann BL, Schatz H, Pfeiffer A.
Universitatsklinikum Essen, Zentrum fur Innere Medizin, Abteilung fur Endokrinologie.
Continuous blood glucose monitoring: the acute effect of acarbose on blood glucose variations.
Monitor the blood glucose in a periodic basis to find out the effect of acarbose on blood glucose variations Monitor the blood glucose in a periodic basis to find out the effect of acarbose on blood glucose variations.
BACKGROUND: Acarbose, a pseudo-tetrasaccharid, inhibits intestinal alpha-glucosidases, effects a reduction of postprandial hyperglycemia and is particularly used in the treatment of patients with type-2 diabetes mellitus. The aim of the study is to analyse by a continuous blood glucose measurement the acute effect of acarbose after a carbohydrate loading and during a 12 hours period. PATIENTS AND METHODS: We examined 10 patients with type-2 diabetes mellitus (mean age 59.2 +/- 3.79, HbA1 9.2 +/- 0.26%) treated with sulfonylureas and/or insulin after a carbohydrate meal and 12 hours during daytime, to test whether the first application of acarbose influences the mean blood glucose or the blood glucose amplitudes. Four measurements were enrolled using a portable continuous blood glucose sensor (Glucosensor, unitec Ulm). A measurement after a carbohydrate loading (Fresubin, 500 kcal, 69 g carbohydrate) with 100 mg acarbose (Glucobay) was followed by a 12-hour measurement during daytime with 3 x 100 mg acarbose and standard diet. These measurements were repeated without acarbose. RESULTS: After a carbohydrate loading, the mean blood glucose level (AUC 44,320 +/- 10,660 with acarbose vs. 61,390 +/- 12,590 without acarbose; mean + SD; p = 0.004) decreased by 28%. During daytime blood glucose levels were not significantly decreased (165.7 +/- 50.3 mg/dl vs 183.7 + 67.4 mg/dl; p = 0.1) although the postprandial blood glucose amplitudes after the 3 meals were reduced significantly (85.90 +/- 24.6 mg/dl vs 106.5 +/- 20.5 mg/dl; p = 0.02). CONCLUSIONS: Continuous blood glucose monitoring indicated that acarbose diminished mean blood glucose levels after a carbohydrate loading in patients with type-2 diabetes mellitus, but not during 12 hours of standard diet, although blood glucose amplitudes decreased. Long-term improvements of metabolism by acarbose may therefore be related to the reduction of blood glucose amplitudes which is likely to reduce toxic effects of glucose on islet cell function.
Diabetes Nutr Metab. 1999 Aug;12(4):277-85.
Hasche H, Mertes G, Bruns C, Englert R, Genthner P, Heim D, Heyen P, Mahla G, Schmidt C, Schulze-Schleppinghof B, Steger-Johannsen G.
Bayer Vital GmbH & Co. KG, PH-Medizin Stoffwechsel, Leverkusen, Germany.
Effects of acarbose treatment in Type 2 diabetic patients under dietary training: a multicentre, double-blind, placebo-controlled, 2-year study.
A multicentre, double-blind, placebo-controlled study for 2-year on the effects of acarbose treatment in Type 2 diabetic patients under dietary training A multicentre, double-blind, placebo-controlled study for 2-year on the effects of acarbose treatment in Type 2 diabetic patients under dietary training.
This 24-months, placebo-controlled, double-blind, randomised, group comparison study investigated the effect of acarbose vs placebo for improving metabolic control in patients with Type 2 diabetes under dietary training insufficiently controlled by diet alone. Patients randomised to acarbose had their dose increased in a stepwise manner to week 5. From week 5 onwards, they received 100 mg three times daily. This incremental dosing scheme was matched in the placebo group. All patients received specialist, intensive, continuous dietary training and counselling throughout the 2 yr of the study. Of the 74 patients randomised, 60 were included in the per-protocol analysis (28 receiving acarbose; 32 receiving placebo). HbA1c was the primary target variable. Per-protocol analysis found that, after 24 months, the mean difference in HbA1c relative to baseline value was -1.71+/-1.6% in the acarbose group and -0.82+/-1.1% in the placebo group. End-point values were 6.85+/-1.7% in the acarbose group and 7.41+/-1.1% in the placebo group. This difference between acarbose and placebo was statistically significant (p=0.02). Patients were defined as responders if they did not require additional treatment with an antidiabetic agent during the study. The responder rate under acarbose therapy was 89%, compared with 47% for placebo (p=0.0005). Acarbose-treated responders improved their HbA1c level to 6.45+/-0.82% after 24 months. The efficacy of acarbose was consistent throughout the study; decreasing efficacy was not evident. The results demonstrate the efficacy of acarbose for improving metabolic control in patients with Type 2 diabetes, even when such patients receive good dietary treatment and counselling.
Diabetes Obes Metab. 2000 Jan;2(1):33-8.
Malaguarnera M, Giugno I, Ruello P, Maugeri D, Pistone G.
Department of Internal Medicine and Geriatrics, University of Catania, Italy.
Treatment of familial hypertriglyceridaemia with acarbose.
Use of acarbose in the treatment of familial hypertriglyceridaemia Use of acarbose in the treatment of familial hypertriglyceridaemia. AIM: The evaluation of serum triglyceride levels has played an important role as an independent method for assessing the risk factor for coronary atherosclerosis. Fibrates, nicotinic acid, and omega-3 polyunsaturated fish oils are the pharmacological tools most used today against hypertriglyceridaemia. Acarbose is a pseudotetrasaccharide of microbial origin which exerts a competitive, selective and reversible inhibition of the intestinal alpha glucoside-hydrolase. We evaluated the efficacy and side-effects of acarbose as a new and alternative drug in the treatment of hypertriglyceridaemia in non-diabetic patients. METHODS: We enrolled 30 non-diabetic patients (18 men, 12 women; mean age 59.23 +/- 6.27 years) without a family history of diabetes mellitus affected by familial hypertriglyceridaemia. The study covered a total period of 6.5 months: half of the patients were on 1.5 months of 'run in' diet only followed by 5 months of therapeutic diet plus acarbose; and half were on the therapeutic diet plus placebo. We gave 30 dividable pills to all patients. The administration was as follows: half a pill before lunch and half a pill before dinner while on the 'run in' diet. Fifteen patients (group A) took acarbose while the reminder (group B) took a placebo (50 mg of starch); these were distributed randomly and the test was double blind. The 20 weeks of study were divided in five 4-week periods. Fasting serum concentrations of total cholesterol, triglycerides, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c) and glucose were determined at the starting of the study and after each treatment cycle. Glucose values were determined 2 h after lunch at the beginning of the study and at the end of the first, third and fifth month of treatment. All parameters assessed have been analysed by anova. RESULTS: The serum total cholesterol, LDL-c levels observed in the two groups did not change during the course of treatment. We observed a noteworthy progressive reduction of mean baseline triglyceride levels until the fourth month (p < 0.05) in acarbose-treated patients, with an increase in HDL-c (p < 0.008). CONCLUSIONS: We maintain that acarbose may be a useful therapeutic tool in addition to the diet in order to reduce triglyceride serum levels in non-diabetic patients.
Eat Weight Disord. 1998 Mar;3(1):46-9.
Bayraktar F, Hamulu F, Ozgen AG, Yilmaz C, Tuzun M, Kabalak T.
Ege University Medical Faculty, Endocrinology Department, Bornova, Izmir, 35100 Turkey.
Acarbose treatment in obesity: a controlled study.
A controlled study on Acarbose treatment for obesity A controlled study on Acarbose treatment for obesity. Acarbose is an alpha-glucosidase inhibitor which reversibly inhibits oligosaccharidase and disaccharidase at the brush border of the small intestine. The aim of this study was to observe its effectiveness in the treatment of obesity. METHODS: Two groups of 25 obese women were put on a 15 kcal/kg/day low-calorie diet for 12 weeks. One group (the study group) received 150 mg/day acarbose for the first 2 weeks and 300 mg/day acarbose for the remaining 10 weeks. The second group (controls) received no additional treatment. Body weight, BMI, skinfold thickness, serum lipids, OGTT, and insulin and C-peptide responses to OGTT were assessed before and after the study. RESULTS: Body weight, BMI and skinfold thickness decreased significantly in both groups. Basal insulin and triglyceride levels in the study group, total and LDL cholesterol and triglyceride levels in the control group decreased significantly. No difference was found between the two groups when these decrements were compared, but the triglyceride level fell more in the control group. CONCLUSION: Additional acarbose therapy is not more beneficial than low-calorie diet therapy alone.
J Gerontol A Biol Sci Med Sci. 2002 Feb;57(2):M111-4.
Ron Y, Wainstein J, Leibovitz A, Monastirsky N, Habot B, Avni Y, Segal R.
Department of Gastroenterology, Wolfson Hospital, Holon, Israel.
The effect of acarbose on the colonic transit time of elderly long-term care patients with type 2 diabetes mellitus.
How acarbose affect on the colonic transit time of elderly long-term care patients with type 2 diabetes mellitus? How acarbose affect on the colonic transit time of elderly long-term care patients with type 2 diabetes mellitus?
BACKGROUND: Constipation is common in elderly patients with diabetes mellitus (DM); its prevalence is estimated as up to 60% among patients with diabetic neuropathy. Acarbose, an alpha-glucosidase inhibitor, has a beneficial role in controlling DM, although one of its side effects is diarrhea. This study evaluates the efficacy of acarbose in improving constipation using transit time (TT) studies in elderly long-term care (LTC) patients. METHODS: Twenty-eight patients with type 2 DM and constipation were recruited for the study. TT was measured by radiopaque markers and was calculated separately for the four segments of the colon (ascending, transverse, descending, and rectosigmoid) and for the total colonic transit time (CTT). Segmental TT and CTT were evaluated in each patient before and after 1 week, and again after 4 weeks of treatment with acarbose. RESULTS: The mean baseline CTT measured in patients was 202 plus minus 136 hours. After 1 and 4 weeks of acarbose treatment, the baseline CTT significantly decreased to 149 plus minus 107 hours and 161 plus minus 97 hours, respectively (p <.002). For each segment studied, the TT was shortened, but it reached significance for the ascending and transverse colon only (p <.02 and p <.03, respectively). The effect of diet composition was examined. The amount of fiber consumed correlated with shortened CTT, while fat tended to be in negative correlation with TT. CONCLUSIONS: Acarbose therapy reduced the extremely prolonged CTT in LTC diabetic persons with constipation. The drug could be useful in relieving constipation in these patients, in addition to its beneficial effect in the control of diabetes.
Diabetes Res Clin Pract. 2003 Jan;59(1):37-42.
Josse RG, Chiasson JL, Ryan EA, Lau DC, Ross SA, Yale JF, Leiter LA, Maheux P, Tessier D, Wolever TM, Gerstein H, Rodger NW, Dornan JM, Murphy LJ, Rabasa-Lhoret R, Meneilly GS.
Division of Endocrinology and Metabolism, University of Toronto, Ont, Canada.
Acarbose in the treatment of elderly patients with type 2 diabetes.
Treatment using acarbose in elderly patients with type 2 diabetes Treatment using acarbose in elderly patients with type 2 diabetes. AIMS: To study the effect of acarbose, an alpha-glucosidase inhibitor, on glycemic control in elderly patients with type 2 diabetes. METHODS: Elderly patients with type 2 diabetes treated with diet alone were randomly treated in a double-blind fashion with placebo (n=99) or acarbose (n=93) for 12 months. RESULTS: After 12 months of therapy, there was a statistically significant difference in the change in glycated haemoglobin (HbA(1c)) (-0.6%) in the acarbose group versus placebo, as well as in the incremental post-prandial glucose values (-2.1 mmol h/l) and mean fasting plasma glucose (-0.7 mmol/l). Although there was no effect of acarbose on insulin release, there was a clear effect of acarbose to decrease relative insulin resistance (-0.8) (HOMA method). In addition, acarbose was generally well tolerated and safe in the elderly; most discontinuations were due to gastrointestinal side effects such as flatulence and diarrhea. There were no cases of hypoglycemia reported, and no clinically relevant changes in laboratory abnormalities or vital signs during the study. CONCLUSIONS: Acarbose improves the glycemic profile and insulin sensitivity in elderly patients with type 2 diabetes who are inadequately controlled on diet alone.
JAMA. 2003 Jul 23;290(4):486-94.
Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M; STOP-NIDDM Trial Research Group.
Research Centre, Centre Hospitalier de l'Universite de Montreal-Hotel-Dieu and Department of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial.
Treatment using acarbose in patients with impaired glucose tolerance and the risk of cardiovascular disease and hypertension: the STOP-NIDDM trial Treatment using acarbose in patients with impaired glucose tolerance and the risk of cardiovascular disease and hypertension: the STOP-NIDDM trial.CONTEXT: The worldwide explosive increase in type 2 diabetes mellitus and its cardiovascular morbidity are becoming major health concerns. OBJECTIVE: To evaluate the effect of decreasing postprandial hyperglycemia with acarbose, an alpha-glucosidase inhibitor, on the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance (IGT). DESIGN, SETTING, AND PARTICIPANTS: International, multicenter double-blind, placebo-controlled, randomized trial, undertaken in hospitals in Canada, Germany, Austria, Norway, Denmark, Sweden, Finland, Israel, and Spain from July 1998 through August 2001. A total of 1429 patients with IGT were randomized with 61 patients (4%) excluded because they did not have IGT or had no postrandomization data, leaving 1368 patients for a modified intent-to-treat analysis. Both men (49%) and women (51%) participated with a mean (SD) age of 54.5 (7.9) years and body mass index of 30.9 (4.2). These patients were followed up for a mean (SD) of 3.3 (1.2) years. INTERVENTION: Patients with IGT were randomized to receive either placebo (n = 715) or 100 mg of acarbose 3 times a day (n = 714). MAIN OUTCOME MEASURES: The development of major cardiovascular events (coronary heart disease, cardiovascular death, congestive heart failure, cerebrovascular event, and peripheral vascular disease) and hypertension (> or =140/90 mm Hg). RESULTS: Three hundred forty-one patients (24%) discontinued their participation prematurely, 211 in the acarbose-treated group and 130 in the placebo group; these patients were also followed up for outcome parameters. Decreasing postprandial hyperglycemia with acarbose was associated with a 49% relative risk reduction in the development of cardiovascular events (hazard ratio [HR], 0.51; 95% confidence interval [CI]; 0.28-0.95; P =.03) and a 2.5% absolute risk reduction. Among cardiovascular events, the major reduction was in the risk of myocardial infarction (HR, 0.09; 95% CI, 0.01-0.72; P =.02). Acarbose was also associated with a 34% relative risk reduction in the incidence of new cases of hypertension (HR, 0.66; 95% CI, 0.49-0.89; P =.006) and a 5.3% absolute risk reduction. Even after adjusting for major risk factors, the reduction in the risk of cardiovascular events (HR, 0.47; 95% CI, 0.24-0.90; P =.02) and hypertension (HR, 0.62; 95% CI, 0.45-0.86; P =.004) associated with acarbose treatment was still statistically significant. CONCLUSION: This study suggests that treating IGT patients with acarbose is associated with a significant reduction in the risk of cardiovascular disease and hypertension.
Diabetes Obes Metab. 2001 Dec;3(6):423-7.
Hauner H, Petzinna D, Sommerauer B, Toplak H.
German Diabetes Research Institute at the Heinrich-Heine-University Dusseldorf, Germany.
Effect of acarbose on weight maintenance after dietary weight loss in obese subjects.
How acarbose affect on weight maintenance after dietary weight loss in obese subjects? How acarbose affect on weight maintenance after dietary weight loss in obese subjects? AIMS: Acarbose is a well established antidiabetic drug and is known to exert a modest weight-lowering effect. The aim of this study was to assess the potential of acarbose to improve weight maintenance after a substantial weight loss by dietary measures in obese subjects. DESIGN: Randomised, double-blind, placebo-controlled trial of the effect of acarbose on weight change over a 6-month follow-up period. PATIENTS AND METHODS: One hundred and ten obese subjects with a BMI > or = 32 and < or = 38 kg/m2 were included in the study and underwent a 10-16-week very-low-calorie diet programme to initiate weight loss. Then, subjects were randomised to receive either acarbose or placebo for 26 +/- 2 weeks. The primary variable was body weight. The primary efficacy analysis was performed in the per-protocol population (n = 75). RESULTS: After an initial mean weight loss of 10.0 +/- 3.4 kg, 54 subjects received acarbose at increasing dosage and 56 subjects received placebo treatment. After 14 weeks of follow-up, there was no change in body weight in the two groups. After 26 weeks, completed by 37 subjects in the acarbose group and by 38 subjects in the placebo group, a small weight regain of 0.6 kg was documented in the latter, whereas no weight increase was observed under acarbose treatment (p = 0.38, analysis of covariance with initial body weight as covariable). CONCLUSION: In obese individuals who undergo a hypocaloric diet and achieve a substantial loss of body weight, acarbose treatment provides only a very modest, not significant benefit to stabilise weight reduction. Thus, acarbose is not a useful adjunct to improve weight maintenance in obese subjects after weight loss.
Diabetes Obes Metab. 2003 Jan;5(1):38-44.
Fischer S, Patzak A, Rietzsch H, Schwanebeck U, Kohler C, Wildbrett J, Fuecker K, Temelkova-Kurktschiev T, Hanefeld M.
Institute and Outpatient Department of Clinical Metabolic Research, Medical Faculty Carl Gustav Carus of the Technical University Dresden, Germany.
Influence of treatment with acarbose or glibenclamide on insulin sensitivity in type 2 diabetic patients.
Acarbose or glibenclamide treatment on type 2 diabetic patients with insulin sensitivity Acarbose or glibenclamide treatment on type 2 diabetic patients with insulin sensitivity. AIM: The aim of our double-blind, placebo-controlled study was to compare the effect of acarbose and glibenclamide on the insulin sensitivity in type 2 diabetes. METHODS: We investigated 77 patients (mean age 58.7 years, mean BMI 27.3 kg/m2), treated by diet alone for at least 4 weeks. The subjects were randomized into three treatment groups for 16 weeks: 100 mg t.i.d. acarbose (n = 25) or 1 mg t.i.d. glibenclamide (n = 27) or one t.i.d. placebo (n = 25). Before and after therapy, the levels of fasting plasma glucose, glycosylated haemoglobin, fasting insulin, plasma glucose and insulin 1 h after a standardized breakfast were measured and insulin sensitivity determined by euglycaemic hyperinsulinaemic clamp test. RESULTS: After the treatment period, BMI in the acarbose and placebo group decreased significantly, whereas in the glibenclamide group a significant increase was observed. Fasting plasma glucose was only significant reduced under glibenclamide. The postprandial glucose decreased significantly after acarbose (13.8 vs. 11.4 mmol/l, p < 0.05) and glibenclamide treatment (14.6 vs. 11.4 mmol/l, p < 0.05) and was unchanged under placebo (13.8 vs. 13.7 mmol/l). The fasting insulin levels remained unchanged in all three groups, whereas postprandial insulin values increased significantly under glibenclamide. Neither acarbose nor glibenclamide significantly changed insulin sensitivity [acarbose: glucose disposal rate before treatment 2.3 mg/kg body weight/min/insulin, after treatment 3.2; glibenclamide 2.2 vs. 2.1; placebo 2.6 vs. 3.0]. CONCLUSIONS: Our results show a more substantial improvement of glucose control under glibenclamide than under acarbose which, however, was not associated with an increase of insulin sensitivity.
Am J Physiol Regul Integr Comp Physiol. 2005 Feb 17;
Savastano DM, Carelle M, Covasa M.
Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA.
Serotonin-type 3 receptors mediate intestinal polycose- and glucose- induced suppression of intake.
Intestinal polycose- and glucose- induced suppression of intake are mediated by Serotonin-type 3 receptors Intestinal polycose- and glucose- induced suppression of intake are mediated by Serotonin-type 3 receptors. Ondansetron, a selective serotonin-type 3 (5-HT3) receptor antagonist, was used to test the hypothesis that duodenal infusion of isosmotic solutions of Polycose or its hydrolytic product glucose, suppressed intake through 5-HT3 receptors. Polycose suppressed sucrose intake across both concentrations infused (132mM, 7.6 +/- 0.6 ml; 263mM, 2.3 +/- 0.5 ml), compared to intake under control conditions (12.6 +/- 0.3 ml, P <0.001). Pretreatment with 1.0 mg/kg ondansetron attenuated reduction of sucrose intake induced only by the highest concentration of Polycose (4.6 +/- 0.8 ml, P=0.004). Dose response testing revealed that suppression of food intake by 263mM Polycose was attenuated by ondansetron administered at 1.0, 2.0, and 5.0mg/kg equally, but not when given at 0.125, 0.25, and 0.5 mg/kg. Acarbose, an alpha-glucosidase inhibitor, attenuated Polycose-induced suppression of food intake and pretreatment with 1.0 mg/kg ondansetron had no further effect. Suppression of intake following 990mM glucose, but not mannitol infusion, was attenuated by pretreatment with 1.0 mg/kg ondansetron. The competitive SGLT1 inhibitor, phloridzin had no effect on 60 min 990mM glucose-induced suppression of intake or the ability of ondansetron to attenuate this suppression of intake. Conversely, glucose-induced suppression of intake was attenuated by phloridzin at earlier time points, and further attenuated when rats were pretreated with 1.0 mg/kg ondansetron. Ondansetron administration alone had no effect on intake at any dose tested. We conclude that 5-HT3 receptors participate in the inhibition of food intake by intraduodenal infusion of carbohydrate solutions through a post-hydrolytic, preabsorptive mechanism.
Diabetes Care. 2005 Mar;28(3):736-44.
Padwal R, Majumdar SR, Johnson JA, Varney J, McAlister FA.
Department of Medicine, 2E3.22 Walter C. Mackenzie HSC, University of Alberta Hospital, 8440-112th St., Edmonton, AB, Canada, T6G 2B7.
A systematic review of drug therapy to delay or prevent type 2 diabetes.
Delay or prevent type 2 diabetes by a regular review of drug therapy.
OBJECTIVE: To systematically review the evidence for the prevention of type 2 diabetes by pharmacological therapies. RESEARCH DESIGN AND METHODS: Randomized controlled trials and cohort studies examining the effect of oral hypoglycemic agents, antiobesity agents, antihypertensive agents, statins, fibrates, and estrogen on the incidence of type 2 diabetes were identified from MEDLINE, EMBASE, the Cochrane Controlled Trials Registry, and searches of reference lists. Two reviewers independently assessed studies for inclusion and performed data extraction. RESULTS: Ten studies of oral hypoglycemic agents and 15 studies of nonoral hypoglycemic agents were found. Oral hypoglycemic agents and orlistat are the only drugs that have been studied in randomized controlled trials with diabetes incidence as the primary end point. In the largest studies of 2.5-4.0 years' duration, metformin (relative risk [RR] 0.69, 95% CI 0.57-0.83), acarbose (0.75, 0.63-0.90), troglitazone (0.45, 0.25-0.83), and orlistat (hazard ratio [HR] 0.63, 95% CI 0.46-0.86) have all been shown to decrease diabetes incidence compared with placebo; however, follow-up rates varied from 43 to 96%. Current evidence for statins, fibrates, antihypertensive agents, and estrogen is inconclusive. In addition, the critical question of whether drugs are preventing, or simply delaying, onset of diabetes remains unresolved. CONCLUSIONS: Currently, no single agent can be definitively recommended for diabetes prevention. Future studies should be designed with diabetes incidence as the primary outcome and should be of sufficient duration to differentiate between genuine diabetes prevention as opposed to simple delay or masking of this condition.
Metabolism. 2005 Mar;54(3):387-90.
Fujisawa T, Ikegami H, Inoue K, Kawabata Y, Ogihara T.
Effect of two alpha-glucosidase inhibitors, voglibose and acarbose, on postprandial hyperglycemia correlates with subjective abdominal symptoms.
How two alpha-glucosidase inhibitors, voglibose and acarbose affect on postprandial hyperglycemia which can be correlated with subjective abdominal symptoms?
To assess the possible difference in effectiveness of 2 alpha-glucosidase inhibitors, voglibose and acarbose, the relationship between postprandial hyperglycemia and subjective abdominal symptoms was investigated. A total of 21 inpatients with type 2 diabetes were recruited to a single-center, 2-period, crossover trial. The subjects were given acarbose (150 mg/d) or voglibose (0.9 mg/d) under an isocaloric diet, and the postprandial (2 hours) increment in blood glucose level, M value which is a marker for fluctuation of blood glucose levels, and subjective abdominal symptom score were monitored. There was no significant difference between the 2 agents in postprandial increment in blood glucose level, M value, and subjective symptom score. When patients were divided according to subjective symptoms, however, the sum postprandial glucose increments were significantly different according to the agent ( P = .03), with favorable efficacy in patients in whom the alpha-glucosidase inhibitor caused abdominal symptoms, demonstrating a significant interaction ( P = .04) between treatment and symptomatic grouping. The results demonstrated that 50 mg acarbose and 0.3 mg voglibose had similar overall effects on postprandial hyperglycemia as well as subjective symptoms, but marked interindividual variation existed. Subjective symptoms may be a predictor of the divergent clinical response to each agent.
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Drug category:Antidiabetic agents
 Acarbose scientific update
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