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Acarbose May Protect Endothelial Function in Type 2 Diabetics

In patients with type 2 diabetes, pre-meal treatment with the alpha-glucosidase inhibitor acarbose may help protect against endothelial dysfunction and perhaps future cardiovascular decline due to postprandial hyperglycemia, research suggests. Japanese clinicians note that, "Postprandial hyperglycemia has been reported to elicit endothelial dysfunction and provoke future cardiovascular complications."

An acarbose-induced reduction in postprandial blood glucose levels was associated with a risk reduction of cardiovascular complications, "but effects of acarbose on endothelial function have never been elucidated," explain Dr. Michio Shimabukuro and colleagues from University of the Ryukyus, Okinawa, Japan.

They assessed the effects of a single pre-meal administration of acarbose and placebo on postprandial glucose excursion and endothelial function after a standard test meal in 14 diet-treated type 2 diabetic patients and 12 age- and sex-matched healthy controls. The meal contained a total of 450 kcal with 15.3% protein, 33.3% fat, and 51.4% carbohydrate.

According to the team, the single test meal impaired forearm endothelial function in diabetic patients but not in control patients. Moreover, "postprandial endothelial dysfunction was improved with a reduction in postprandial hyperglycemia by acarbose," they report.

These are "important observations says," Dr. Shimabukuro. He also noted that that "lifelong endothelial function is essential to protect the body from lifelong vascular events such as myocardial infarction and cerebrovascular attack."

Acarbose, Dr. Shimabukuro and colleagues conclude, "might be a promising oral prandial therapy in treating endothelial function seen in patients with type 2 diabetes mellitus by decreasing the postprandial glucose excursion."
J Clin Endocrinol Metab 2006;91:837-942.