New research suggests that when combined with lifestyle modification, treatment with the alpha- glucosidase inhibitor, voglibose, may help prevent Type 2 diabetes in high-risk individuals with impaired glucose tolerance…
Dr. Ryuzo Kawamori, from Juntendo University School of Medicine, Tokyo, as reported in The Lancet, assessed the occurrence of diabetes in 1,780 high-risk subjects who were randomized to receive voglibose (0.2 mg) or placebo three times daily.
The subjects continued the assigned treatment until diabetes or normoglycemia developed or for a minimum of 3 years. All subjects ate a standard diet and exercised regularly.
Among them, 897 took voglibose three times a day, while 883 were given placebos.
Fifty of the voglibose patients went on to develop diabetes, compared to 106 in the placebo group — which meant that those treated with voglibose had a 40 percent lower risk of progression to Type 2 diabetes than those receiving placebo.
Furthermore, patients on voglibose were 54 percent more likely to achieve normal blood sugar levels than those given placebo.
“This study showed that, if best efforts to educate individuals do not work, treatment with voglibose could be an important way forward,” said Andre Scheen of the division of diabetes at Belgium’s University of Liege.
The authors found that during an average treatment period of 48.1 weeks, subjects given the active agent were 40% less likely to develop diabetes than those who received placebo (p = 0.0014).
Ninety percent of voglibose-treated subjects and 85% of those given placebo had an adverse event. Serious adverse events seen in the voglibose group included one case each of cholecystitis, colonic polyp, rectal neoplasm, inguinal hernia, liver dysfunction, and subarachnoid hemorrhage. Serious events in the placebo group were cerebral infarction and cholecystitis.
In a related editorial, Dr. Scheen comments that while the current findings are encouraging, it still remains to be determined whether voglibose use and other preventive strategies can reduce diabetes morbidity and mortality.
Voglibose is not available in the U.S.. Other alpha-glucosidase inhibitors available in the U.S. are Glycet and Precose.
The Lancet, online edition April, 22 2009.