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Acarbose Improves Insulin Levels in Overweight Women With PCOS

Acarbose, an alpha-glucosidase inhibitor, improves hyperinsulinemia in overweight women with polycystic ovarian syndrome (PCOS), according to a report in the October issue of Fertility and Sterility.

Acarbose reduces postprandial insulin and glucose levels by preventing the transformation of disaccharides to monosaccharides and, thereby, retards the uptake of monosaccharides, the authors explain.

Dr. Semith Tugrul and colleagues from Zeynep Kamil Women’s and Children’s Hospital, Istanbul, Turkey investigated the clinical, endocrinological, and metabolic effects of acarbose 300 mg/d in 74 overweight and nonoverweight women with PCOS.

Acarbose treatment for 3 months produced significant decreases in testosterone and VLDL-cholesterol and significant increases in HDL-cholesterol, the authors report.

Basal insulin levels were higher in the overweight women than in the nonoverweight women before and after acarbose treatment, the researchers note, although there was an important decline in insulin levels in overweight women after treatment.
Overweight women experienced a more significant increase in the fasting glucose/insulin ratio than did nonoverweight women, the investigators say.

About a quarter of the women receiving acarbose experienced abdominal pain, distention, or diarrhea, but this disappeared when the dose was decreased to 150 mg/day for 10-15 days and later returned to 300 mg/day.

"Correction of hyperinsulinemia is central to the treatment of PCOS, and acarbose seems to be an effective drug to be used in overweight patients with PCOS," Dr. Tugrul and associates conclude.

Fertil Steril 2008;90:1144-1148.