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Issue 113 Item 2 Precose(R) Delays the Onset of Type 2 Diabetes

Study findings showed a 25% risk reduction to developing diabetes. Acarbose, sold in the U.S. as Precose(R), is approved for use in treating type 2 diabetes by lowering blood sugar levels after meals. Results from an international study reported in the June 15, 2002 issue of the journal The Lancet, however, suggest that the medication may delay the development of type 2 diabetes among patients with impaired glucose tolerance.

Impaired glucose tolerance is a condition in which blood sugar levels are continually higher than normal, and is considered a precursor to type 2 diabetes, in which the body continues to produce insulin, but loses its ability to use the hormone. The world-wide increase in cases of type 2 diabetes is a major health concern.

The study involved about 1,400 people with impaired glucose tolerance, from Canada, Germany, Austria, Norway, Denmark, Sweden, Finland, Israel, and Spain. Patients were randomly assigned to receive either 100 mg acarbose or an inactive placebo three times daily for at least three years. The measure of effectiveness in the treatment was whether participants developed diabetes, as indicated on the basis of a yearly oral glucose tolerance test.

Study findings showed that 10 percent fewer patients developed diabetes in the acarbose group than in the placebo group (32 percent compared to 42 percent, respectively), which is a relative reduction in risk of 25%. Furthermore, among patients taking acarbose, there was a significant increase in the number whose impaired glucose tolerance reverted back to normal glucose tolerance.

The main side effects of acarbose are flatulence and diarrhea. In this study, 31% of patients given acarbose and 19% of patients given placebo discontinued treatment early.

According to Jean-Louis Chiasson of the University of Montreal, "Lifestyle modification has already been shown to prevent type-2 diabetes. Our results show that intervention with acarbose is also effective. Whether these two treatment options can be used together remains to be determined. Nevertheless, recommendations for screening and treatment of impaired glucose tolerance should now be reasses