Issue 211 Item 6 Acarbose Provides Cardioprotective Effects

Treatment of postprandial glucose excursions provides protection against prethrombotic episodes. Recent data suggest cardio-protective effects by treatment with the alpha glucosidase inhibitor Acarbose, an oral hypoglycemic agent which directly targets postprandial glucose excursions. It is not clear, how this interferes with the pathophysiology of atherothrombotic endpoints which are clearly driven by coagulation mechanisms. Therefore, we intended to display the overall balance of the coagulation and fibrinolysis system under acarbose therapy.

Fibrinogen, tissue factor/ inhibitor, thrombomodulin, PAI-1, t-PA, p-selectin, were measured as secondary outcome parameters in a multicentre, randomized, placebo controlled, double-blind group comparison study of the effects of Acarbose upon cholesterol synthesis and absorption. 32 T2D patients (BMI= 29.5±3.5 kg/m2 , age 61.7,±8.3 years, HBA1c 7.8±1.0 %) were randomized and then treated with 100 mg Acarbose tid over 16 weeks. Here, the results of the ITT analysis of the secondary endpoint parameters are presented. 16 weeks of Acarbose treatment was associated with a significant reduction of fasting fibrinogen values (-137.3 mg/dl, CI -243.6 -30.9, p=0.013) and a trendwise reduction in postprandial fibrinogen (-73.3 mg/dl, CI -170.3 23.7, p=0.13). All other index molecule concentrations measured did not show any difference along with Acarbose treatment.

Fibrinogen has been shown as an independent predictor of ischemic vascular endpoints. The remarkable reduction of this procoagulant substrate in this study suggests that Acarbose effects exceed the reduction of postprandial glucose spikes by positive modulation of the hemostatic balance in diabetic patients assumed to be in a prethrombotic condition. This could help to explain the straight forward benefit of Acarbose treatment upon cardiovascular endpoints. Abstract 64th Scientific Sessions

===========================

DID YOU KNOW: Carbohydrate cravings may be more than just a desire for donuts — researchers say they could be a sign of atypical depression, which affects up to forty million Americans — mostly women — with symptoms of cravings, weight gain and unexplained tiredness. New data presented on June 2 at a major research conference* show an over-the-counter nutritional supplement, chromium picolinate, helps curb the most severe carb cravings. The new study showed people who took chromium picolinate daily experienced a significant reduction in carb cravings, and improvements in symptoms of fatigue and mood swings in just 30 days. —Pblished findings from Duke University.