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Item #10 

Acarbose Effective in the Treatment of the Elderly

Acarbose can decrease relative insulin resistance safely

The study was done to find the effect of acarbose, an -glucosidase inhibitor, on glycemic control in elderly patients with type 2 diabetes.

Elderly patients with type 2 diabetes treated with diet alone were randomly treated in a double-blind fashion with placebo (n=99) or acarbose (n=93) for 12 months.

The results showed that after 12 months of therapy, there was a statistically significant difference in the change in glycated haemoglobin (HbA_1c) (-0.6%) in the acarbose group versus placebo, as well as in the incremental post-prandial glucose values (-2.1 mmol h/l) and mean fasting plasma glucose (-0.7 mmol/l). Although there was no effect of acarbose on insulin release, there was a clear effect of acarbose to decrease relative insulin resistance (-0.8) (HOMA method). In addition, acarbose was generally well tolerated and safe in the elderly; most discontinuations were due to gastrointestinal side effects such as flatulence and diarrhea. There were no cases of hypoglycemia reported, and no clinically relevant changes in laboratory abnormalities or vital signs during the study.

From the results it was concluded that acarbose improves the glycemic profile and insulin sensitivity in elderly patients with type 2 diabetes who are inadequately controlled on diet alone. Diabetes Research and Clinical Practice Volume 59, Issue 1, January 2003, Pages 37-42

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