Source: Gut  |  Posted 8 years ago

Acarbose appears to reduce insulin resistance and triglyceride levels in obese hypertensive subjects with normal glucose tolerance, according to new research findings.

Acarbose is a glucose oxidase inhibitor that delays the absorption of glucose and therefore reduces post-prandial blood glucose level, haemoglobin A1c (HbA1c) and insulin resistance in patients with diabetes mellitus and/or impaired glucose tolerance. However, the effect of acarbose in subjects with normal glucose tolerance (NGT) has not been determined.

Rita Rachmani, MD, with the Tel-Aviv University, Israel, and colleagues conducted a double-blinded, parallel group study on 56 male subjects with hypertension, body mass index (BMI) 27-35 kg/m[^]2[], fasting blood glucose 6 mol/L or less, and NGT.

Blood pressure, HbA1c, lipid profile and insulin resistance [homeostasis model assessment (HOMA) index] were measured at baseline and following 24 weeks of acarbose, 150 mg/day or placebo.

Insulin resistance decreased in subjects using acarbose but not in those taking placebo, the researchers report. In addition, HOMA index declined from 5.36 ? 1.7 to 4.10 ? 1.6 ([]P[] = .001) in subjects taking acarbose, but increased slightly in those taking placebo.

Likewise, serum triglyceride values decreased in patients taking acarbose (2.16 ? 0.16 mol/L to 1.76 ? 0.15 mol/L, []P[] = 0.02) but remained unchanged in those taking placebo.

BMI, low-density lipoprotein and high-density lipoprotein values remained unchanged in both groups, while blood pressure declined equally in both the groups.

According to the researchers, the results indicate that pharmacological intervention with acarbose in patients with normal glucose tolerance can decrease insulin resistance and serum triglyceride values.

"The small dose of acarbose is well tolerated with infrequent and minor abdominal symptoms as compared to the double-dose used in patients with diabetes," Dr. Rachmani and colleagues note.

"It is therefore possible to speculate that the use of acarbose in selected obese hypertensive patients may delay their transition to IGT and possibly retard the progression of vascular changes," the researchers add. "Further experimental as well as clinical studies are needed in order to clarify this issue," they suggest.