[ Nutrition ]

Effect of Add-On Acarbose to Insulin Therapy

The SHR/N-corpulent (cp) rat exhibits some of the metabolic characteristics associated with human noninsulin-dependent diabetes mellitus (NIDDM). After a 4-week placebo run-in period, subjects were randomized to either acarbose (titrated up to 100 mg b.i.d.) or placebo. MNT was provided for each patient based on personal requirements as defined by a dietitian. Subgroup analyses did not find significant differences in subgroups stratified by sex, age, and underlying diseases. This study was undertaken to investigate whether concomitant administration of Beano and acarbose could reduce the flatulence associated with acarbose and, if so, whether Beano would interfere with the effects of acarbose on postprandial serum glucose concentration. The decrease was greater in the two groups receiving active therapy compared with placebo (acarbose –2.3 ± 0.32%; metformin –2.5 ± 0.16%; placebo –1.3 ± 0.34%). There was no difference in carbohydrate intake between those who dropped out of the study because of gastrointestinal side effects and those who did not, and there was no relationship between severity of symptoms and the composition of the diet.

Comparable results were obtained in combination with conventional, functional or intensive insulin therapy. 136 +/- 13 mg/dl; p < 0.01), mean variation (180 +/- 14 vs. Marked reductions were also achieved in the IGT population (0.9% for HbA1c, 11.8 mg/dL for FBG and 42.9 mg/dL for 2-hour postprandial BG) despite lower baseline glucose levels in this group than in patients with type 2 diabetes. The majority of patients assessed acarbose treatment positively. However, clinicians must be aware of the possibility of hyperammonemia when they prescribe acarbose for patients with diabetes mellitus and advanced liver cirrhosis. There is increasing evidence that highly elevated postprandial blood glucose is considered to be an independent risk factor for the development of diabetes complications.[4-6] Several reviews have been published on this subject[7-12] and suggest that targeting postprandial glucose levels could be a useful therapeutic strategy in diabetes management.

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