Acarbose best suited for newly diagnosed type 2 diabetes patients with obesity
China: Acarbose is the first glucosidase inhibitor used in the clinical therapy of type 2 diabetes mellitus (T2DM). The mode of action is that it may delay the absorption of carbohydrates in the intestine to reduce postprandial blood sugar.
A new study published in BMC Pharmacology and Toxicology found Acarbose therapy to be more effective in patients with newly diagnosed type 2 diabetes with low fasting blood sugar, obesity, and low 2-h postprandial blood sugar.
The researchers further suggest that the earlier the diagnosis of type 2 diabetes and continuously treated with Acarbose, the better the response to the treatment will be.
For patients with the diagnosis of type 2 diabetes mellitus (T2DM) diagnosis, Acarbose is one of the optimal drugs. But there is no reporting on emerging patients with the best therapeutic response to acarbose therapy. Considering this, Rong Zhang and the research team from China aimed to investigate the predictors of acarbose therapeutic efficacy in patients with a new diagnosis of T2DM.
Participating in the MARCH study (Study of Acarbose in Newly Diagnosed Patients with T2DM in China), 346 patients with type 2 diabetes received acarbose monotherapy for 48weeks from November 2008 to June 2011.
Change in glycated hemoglobin (ΔHbA1c) was the dependent variable. The assessment of different baseline variables such as sex, age, body mass index (BMI), disease duration, weight, diastolic blood pressure (DBP), systolic blood pressure (SBP), fasting plasma glucose, HbA1c, 2-h postprandial blood glucose, 2-h postprandial insulin, fasting insulin, HOMA-IR, early insulin secretion index (IGI), is under the curve of glucagon (AUC), GLP-1, and insulin were done as independent predictors.
The study led to the following findings:
- At 12 weeks, independent predictors of ΔHbA1c included baseline DBP (β=0.010), body weight (β=−0.012), FPG (β=0.111), and two h PG (β=0.042).
- At 24 weeks, independent predictors of ΔHbA1c included disease duration (β=0.040) and FPG (β=0.117).
- Finally, an independent predictor of ΔHbA1c at 48weeks was disease duration (β=0.038).
"Factors that can be used for predicting the short-term effectiveness of acarbose monotherapy among patients with a new diagnosis of type 2 diabetes include baseline DBP, body weight, fasting blood sugar, and two h PG," the researchers wrote in their conclusion. "In addition, patients with low two h PG, low FPG, and obesity may achieve a better efficacy of acarbose treatment."
"The earlier type 2 diabetes is diagnosed and continuously given acarbose treatment, the better the response to therapy will be."
The study recruited only patients with newly diagnosed T2DM, which may not represent the general population of T2D patients. Also, the study's sample size was relatively small, and bias may be present. The researchers, therefore, warrant further studies with larger sample sizes to confirm the findings. Also, the follow-up of the study was only for 48 weeks. Long-term follow-up might be required to investigate and predict the long-term efficacy of acarbose monotherapy.
Reference:
The study, "Predictors of acarbose therapeutic efficacy in newly diagnosed type 2 diabetes mellitus patients in China," was published in BMC Pharmacology and Toxicology.
DOI: 10.1186/s40360-022-00621-2
