This paper is only available as a PDF. To read, Please Download here.
Postprandial hyperglycemia and elevations in glycated hemoglobin A1c (HbA1c) levels have been associated with long-term complications of diabetes. Because not all patients with type II, or non-insulin-dependent diabetes mellitus (NIDDM), respond adequately to diet, exercise, or treatment with oral sulfonylurea drugs, alternate therapies have been investigated. Acarbose, the first α-glucosidase inhibitor available in the United States, exerts its activity in the gastrointestinal tract. By reversibly inhibiting the enzymatic cleavage of complex carbohydrates to simple absorbable sugars, treatment with acarbose results in a reduction in postprandial blood glucose and, subsequently, reductions in HbA1c levels. Acarbose may be given as monotherapy with diet or in combination with diet and a sulfonylurea drug. The results of several controlled clinical studies conducted in the United States are reviewed here. Acarbose, in doses of up to 100 mg three times daily for periods of up to 16 weeks, was statistically significantly superior to placebo with respect to the mean reduction in HbA1c levels and mean 1-hour postprandial glucose levels. Adverse events were nonsystemic and primarily gastrointestinal in nature. Acarbose represents a new approach to the management of NIDDM, modulating gastrointestinal carbohydrate metabolism to control postprandial hyperglycemia and to maximize long-term glycemic control.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Clinical Therapeutics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Diabetes in urban African Americans. V. Use of discussion groups to identify barriers to dietary therapy among low-income individuals with non-insulin-dependent diabetes mellitus.Diabetes Educ. 1996; 22: 488-492
- Comparative validity of a food frequency questionnaire for adults with IDDM.Diabetes Care. 1995; 18: 1249-1254
- The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.NEJM. 1993; 329: 977-986
- The Diabetes Control and Complications Trial (DCCT) Research Group. Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial.Kidney Int. 1995; 47: 1703-1720
- The Diabetes Control and Complications Trial Research Group. The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin-dependent diabetes mellitus.Arch Ophthalmol. 1995; 113: 36-51
- Sulfonylureas. Why, which, and how.Diabetes Care. 1990; 13 (Suppl 3): 18-25
- Comparative tolerability profiles of oral antidiabetic agents.Drug Saf. 1994; 11: 223-241
- Pharmacology of α-glucosidase inhibition.Eur J Clin Invest. 1994; 24 (Suppl 3): 3-10
- Alpha-glucosidase inhibitors in diabetes: Efficacy in NIDDM subjects.Eur J Clin Invest. 1994; 24 (Suppl 3): 31-35
- Reduction of glycosylated hemoglobin and postprandial hyperglycemia by acarbose in patients with NIDDM.Diabetes Care. 1995; 18: 817-824
Data on file. Bayer Corporation, Pharmaceutical Division, West Haven, Connecticut, 1989.
- Diabetes Control and Complications Trial Research Group. Assessment of hemoglobin A1c in the Diabetes Control and Complications Trial (DCCT).Clin Chem. 1987; 33: 2267-2271
- Long-term efficacy and safety of acarbose in the treatment of obese subjects with non-insulin-dependent diabetes mellitus.Arch Intern Med. 1994; 154: 2442-2448
- Multicenter, placebo-controlled trial comparing acarbose (BAY g 5421) with placebo, tolbutamide, and tolbutamide-plus-acarbose in non-insulin-dependent diabetes mellitus.Am J Med. 1995; 98: 443-451
- Acarbose efficacy review.Pract Diabetes. 1993; 10 (Suppl 6): S21-S27
- American Diabetes Association. Implications of the Diabetes Control and Complications Trial.Diabetes Care. 1993; 16: 1517-1520
- United Kingdom Prospective Diabetes Study (UKPDS). 13: Relative efficacy of randomly allocated diet, sulfonylurea, insulin, or metformin in patients with newly diagnosed non-insulin-dependent diabetes followed for three years.BMJ. 1995; 310: 83-88
© 1997 Published by Elsevier Inc.