engleski

Benefits of Acorbose Use in Patients with Non-insulin Dependent Diabetes Mellitus

This multicentric (11 centers) study included 104 patients with non-insulin dependent diabetes mellitus (NIDDM). The efficacy and safety of acarbose (Glucobay) were assessed during a three-month period. Acarbose was introduced in the treatment of patients previously treated according to one of the following protocols which proved inadequate: group 1 - basic treatment only ; group 2 - combination of basic treatment and sulfonylureas ; and group 3 - combination of basic treatment and insulin. Comparing the decrease in the fasting and 1-hour postprandial blood glucose values among the three groups of patients, the most pronounced glucoregulatory effect of acarbose was recorded in the group of patients previously treated with a combination of basic and insulin therapy, followed by the group on a combination of basic therapy and sulfonylurea, and the group on basic therapy. Comparison of the HbA1c percentage decrease yielded the same order of acarbose efficacy. The mean values of HbA1c in the three treatment groups (insulin, sulfonylurea and basic therapy) were 9.88± 1.22%, 9.87± 1.45% and 8.76± 1.29% at the beginning, and 8.48± 1.44% (p<0.01), 8.99± 1.42% (p<0.01) and 8.17± 1.11% (p>0.05) at the end of the study, respectively. Differences were statistically significant for the insulin and sulfonylurea group, and nonsignificant for the basic treatment group. The most frequently reported side effects in all the three patient groups were gastrointestinal symptoms such as meteorism (21%) and flatulence (24%) of moderate severity. Other side effects (three or more stools per day, diarrhea, abdominal pain, and nausea) were reported by 2% - 4% of patients. The side effects were reversible and could be alleviated by acarbose dosage reduction. Only 2% of the patients discontinued the use of acarbose because of diarrhea. Accordingly, in the three groups of patients with NIDDM and high postprandial glycemia who had previously been treated with insulin, sulfonylurea or diet alone, a significant decrease in the mean fasting and 1-hour postprandial blood glucose values was recorded upon the introduction of acarbose. The most pronounced glucoregulatory benefit as assessed by HbA1c decrease was achieved in the groups of patients on insulin and sulfonylurea, while in the group of patients on diet alone it was present but not statistically significant. Side effects were reversible upon the reduction of acarbose dosage. Only 2% of the patients discontinued the use of acarbose due to diarrhea.

non-insulin dependent diabetes mellitus; acarbose; efficacy; safety

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