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Treatment of postprandial hyperglycemia with acarbose did not prevent or delay disease progression in patients with early type 2 diabetes. A group of researchers led by Dr Sue Kirkman of the Indiana University School of Medicine in Indianapolis, USA, assessed whether treatment of postprandial hyperglycaemia with acarbose would prevent or delay the progression of diabetes. A total of 219 patients with early type 2 diabetes (fasting plasma glucose [FPG] <140mg/dL and 2-hour plasma glucose 200mg/dL or higher) were randomized to acarbose 100mg 3 times daily or placebo. Treatment continued for 5 years or until FPG was 140mg/dL or higher in 2 consecutive quarterly assessments. Secondary outcomes included oral glucose tolerance tests (OGTTs), measures of insulin resistance, and secondary measures of beta-cell function.
The researchers found that treatment with acarbose reduced postprandial hyperglycaemia, but did not reduce the cumulative rate of progression to fasting hyperglycaemia (29% with acarbose vs 34% with placebo; p=0.65). Results from OGTTs, measures of insulin resistance, and secondary measures of beta-cell function did not differ between treatment groups. Among patients with baseline FPG <126mg/dL, fewer patients treated with acarbose progressed to FPG 126mg/dL or higher (27% vs 50%; p=0.04), according to a post hoc analysis.
The researchers concluded that treatment of postprandial hyperglycaemia with acarbose did not prevent or delay disease progression in patients with early type 2 diabetes.
Diabetes Care 2006;29:2095-101
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