Precose Unlikely to Slow Type 2 Diabetes Progression

Treating “postprandial hyperglycemia” — the spike in blood sugar that occur after meals — with the drug Precose (also known as acarbose) does not delay the progression of early type 2 diabetes, according to a study. Postprandial hyperglycemia is a hallmark of early type 2 diabetes and the resultant sugar overload may lead to
progressive beta-cell dysfunction. Therefore, treating this hyperglycemia could potentially slow disease progression.
To investigate, Dr. M. Sue Kirkman, from Indiana University School of Medicine in Indianapolis, and colleagues assessed the outcomes of 219 patients with early type 2 diabetes who were randomized to receive acarbose or placebo for 5 years or until they had developed frank hyperglycemia, defined as two consecutive quarterly fasting glucose measurements of 140 mg/dL or more.

While acarbose was effective in reducing the post-meal spike in blood sugar, this benefit did not translate into a delay in disease progression.

Twenty-nine percent of acarbose-treated patients progressed to frank hyperglycemia, not significantly different from the 34 percent who progressed in the control group.

There was also no evidence that acarbose improved insulin resistance or beta-cell function. However, in patients with an initial fasting plasma glucose level of <126 mg/dL, acarbose therapy did seem to prevent progression to higher levels.

Since, overall, ameliorating postprandial hyperglycemia did not delay diabetes progression, other factors "may be greater determinants of progression of diabetes," the investigators conclude.

Diabetes Care September 2006.

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