title: Efficacy and safety of acarbose in metformin-treated patients with type 2 diabetes.
abstract: OBJECTIVE
  To demonstrate the efficacy, tolerability, and safety of acarbose compared with placebo in patients with type 2 diabetes inadequately controlled with diet and metformin (2,000 or 2,500 mg/day in divided doses).
  
  
  METHODS
  This study had a multicenter randomized double-blind placebo-controlled parallel-group comparison design. The trial lasted 31 weeks and consisted of a 1-week screening period, a 6-week placebo pretreatment period, and a 24-week period of acarbose or placebo, with a forced titration from 25-50 mg t.i.d. and a titration of 50-100 mg tid that was based on glucose control. The primary efficacy variable was the mean change from baseline in HbA1c. Secondary efficacy variables included mean changes from baseline in fasting and postprandial plasma glucose, serum insulin, and triglyceride levels.
  
  
  RESULTS
  The addition of acarbose to patients on background metformin and diet therapy showed a statistically significant reduction in mean HbA1c of 0.65%. There were statistically significant reductions in fasting and postprandial plasma glucose and serum insulin levels compared with placebo. Gastrointestinal side effects were more frequently reported in the acarbose-treated patients. No significant differences in liver transaminase elevations were observed between patients treated with acarbose and those treated with placebo.
  
  
  CONCLUSIONS
  The results of this study demonstrate that the addition of acarbose to patients with type 2 diabetes who are inadequately controlled with metformin and diet is safe and generally well tolerated and that it significantly lowers HbA1c and fasting and postprandial glucose and insulin levels.
authors.affiliation: Dallas Diabetes and Endocrine Center, TX 75230, USA.
authors.forename: J
authors.initials: J
authors.lastname: Rosenstock
authors.forename: A
authors.initials: A
authors.lastname: Brown
authors.forename: J
authors.initials: J
authors.lastname: Fischer
authors.forename: A
authors.initials: A
authors.lastname: Jain
authors.forename: T
authors.initials: T
authors.lastname: Littlejohn
authors.forename: D
authors.initials: D
authors.lastname: Nadeau
authors.forename: A
authors.initials: A
authors.lastname: Sussman
authors.forename: T
authors.initials: T
authors.lastname: Taylor
authors.forename: A
authors.initials: A
authors.lastname: Krol
authors.forename: J
authors.initials: J
authors.lastname: Magner
mesh_terms: D020909:Acarbose; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy*; D004311:Double-Blind Method; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D008297:Male; D008687:Metformin / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008875:Middle Aged; D010919:Placebos; D019518:Postprandial Period; D014280:Triglycerides / Q000097:blood; D014312:Trisaccharides / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D020909:Acarbose; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D010919:Placebos; D014280:Triglycerides; D014312:Trisaccharides