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Abstract
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.
Keywords
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© 1997 Published by Elsevier Inc.
