Comparison of acarbose and metformin therapy in newly diagnosed type 2 diabetic patients with overweight and/or obese.
Curr Med Res Opin. 2016 Apr 7;:1-34
Authors: Sun W, Zeng C, Liao L, Chen J, Wang Y
Abstract
OBJECTIVE: To compare the efficacy of acarbose and metformin in overweight and/or obese patients with newly diagnosed type 2 diabetes mellitus (T2DM).
METHODS: A total of 108 drug-naïve patients with newly diagnosed T2DM, whose hemoglobin A1c (HbA1c) was between 7% and 10% and body mass index greater than 24 kg/m(2), were enrolled in the First People's Hospital and Municipal Central Hospital of Xiangtan City, Xiangtan, China, from February 1, 2010, to August 1, 2011. Patients were randomly assigned to acarbose (100-mg tid) and metformin (1.5 g/day) groups for a predictive follow-up period of 24 weeks. Plasma glucose, insulin, and glucagons at 0, 0.5, and 2 hours after a standardized meal, and HbA1c were measured at baseline and 24 weeks.
RESULTS: Baseline characteristics of the acarbose and metformin groups were even. Glucose control improved significantly in both groups at 24 weeks. The percentage of patients achieving HbA1C < 6.5% was comparable for acarbose and metformin therapy at 24 weeks. Body weight reduction from baseline to 24 weeks was 3.3 kg in the acarbose group and 2.7 kg in the metformin group, whereas the change of HbA1c and body weight was similar in both groups. The early-phase insulin secretion index improved only in the acarbose group at 24 weeks. After a 24-week therapy, fasting glucagon and 0.5-hour postprandial glucagon levels markedly decreased in the acarbose group than in the metformin group.
CONCLUSIONS: The 24-week therapy of acarbose and metformin induced the similar reductions of HbA1c and body weight, however, acarbose showed superior efficacy in improving islet α-cell function compared with metformin in overweight/obese patients with newly diagnosed T2DM. However, the results needed more large-sample, multicentre, randomised controlled trails to evaluate the efficacy, safety, cost-effectiveness, and glycemic variability of the two drugs.
PMID: 27052634 [PubMed - as supplied by publisher]