Acarbose in the treatment of elderly patients with type 2 diabetes.
OBJECTIVE
To study the effect of acarbose, an alpha-glucosidase inhibitor, on glycemic control in elderly patients with type 2 diabetes.


METHODS
Elderly patients with type 2 diabetes treated with diet alone were randomly treated in a double-blind fashion with placebo (n=99) or acarbose (n=93) for 12 months.


RESULTS
After 12 months of therapy, there was a statistically significant difference in the change in glycated haemoglobin (HbA(1c)) (-0.6%) in the acarbose group versus placebo, as well as in the incremental post-prandial glucose values (-2.1 mmol h/l) and mean fasting plasma glucose (-0.7 mmol/l). Although there was no effect of acarbose on insulin release, there was a clear effect of acarbose to decrease relative insulin resistance (-0.8) (HOMA method). In addition, acarbose was generally well tolerated and safe in the elderly; most discontinuations were due to gastrointestinal side effects such as flatulence and diarrhea. There were no cases of hypoglycemia reported, and no clinically relevant changes in laboratory abnormalities or vital signs during the study.


CONCLUSIONS
Acarbose improves the glycemic profile and insulin sensitivity in elderly patients with type 2 diabetes who are inadequately controlled on diet alone.
Josse
R G
RG
Division of Endocrinology and Metabolism, University of Toronto, Ont, Canada.
Chiasson
J-L
JL
Ryan
E A
EA
Lau
D C W
DC
Ross
S A
SA
Yale
J-F
JF
Leiter
L A
LA
Maheux
P
P
Tessier
D
D
Wolever
T M S
TM
Gerstein
H
H
Rodger
N W
NW
Dornan
J M
JM
Murphy
L J
LJ
Rabasa-Lhoret
R
R
Meneilly
G S
GS
D020909:Acarbose / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005414:Flatulence / Q000139:chemically induced; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D020909:Acarbose