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Acarbose May Delay Development Of Type-2 Diabetes
A DGReview of :"Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial"
Lancet
06/13/2002
By Harvey McConnell
An international study indicates acarbose could be used to delay the development of Type II diabetes in patients with impaired glucose tolerance.
A randomized placebo controlled trial directed by Dr Jean-Louis Chiasson, Research Centre, Centre Hospitalier de l'Université de Montréal, Hôtel-Dieu, Montreal, Quebec was carried out among 1,429 patients with impaired glucose tolerance. Patients were from Canada, Austria, Denmark, Finland, Israel, Germany, Norway and Sweden.
They were recruited to the Study To Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) trial, mainly through screening of high-risk populations, especially first-degree relatives of patients with Type II diabetes. Men and women were screened who were between the ages of 40 to 70 and who had a body-mass index of between 25 and 40 kg/m.
Researchers assigned 714 patients with impaired glucose tolerance to acarbose (100 mg ) and 715 to placebo three times daily. The primary endpoint was the development of diabetes on the basis of a yearly oral glucose tolerance test. Overall, 211 (32 percent) of 682 patients in the acarbose group and 130 (19 percent) of 686 on placebo discontinued treatment early.
Investigators found that 10 percent fewer patients given acarbose developed diabetes: 221 (32 percent) of patients randomized to acarbose and 285 (42 percent) randomised to placebo. This is a relative reduction in risk of 25 percent.
At the same time, acarbose significantly increased reversion of impaired glucose tolerance to normal glucose tolerance. The main side effects of acarbose were flatulence and diarrhoea.
Dr Chiasson and colleagues conclude: "Lifestyle modification has already been shown to prevent Type II diabetes. Our results show that intervention with acarbose is also effective. Whether these two treatment options can be used together remains to be determined. Nevertheless, recommendations for screening and treatment of impaired glucose tolerance should now be reassessed."
Lancet 2002; 359: 2072-77.
"Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial"
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