title: A study of the effects of acarbose on glucose metabolism in patients predisposed to developing diabetes: the Dutch acarbose intervention study in persons with impaired glucose tolerance (DAISI).
abstract: BACKGROUND
  We hypothesized that acarbose would delay conversion from impaired glucose tolerance (IGT) to type 2 diabetes by alleviating postprandial hyperglycaemia. Our study's main objective was to investigate the effect of acarbose in IGT-persons on their 2-h plasma glucose level and beta-cell function.
  
  
  METHODS
  The study included a random sample of 45-70-year-old residents of Hoorn, Netherlands, with mean fasting plasma glucose < 7.8 mmol/L and mean 2-h plasma glucose of 8.6-11.1 mmol/L (measured by two successive oral glucose tolerance tests). After a qualification period, participants were randomized to acarbose treatment or placebo. Insulin secretion and insulin sensitivity were measured by hyperglycaemic clamp. After a 3-year treatment, analyses were performed of both the intention-to-treat and the per-protocol groups.
  
  
  RESULTS
  Of the 12 093 residents who received postal invitations, 118 participants were randomized. The mean difference of the post-load plasma glucose after 3 years, was - 1.16 mmol/L (95% CI: - 2.03; - 0.17). The absolute risk reduction for diabetes was 6% (95% CI: - 9; 21). No effect was seen on insulin secretion and insulin sensitivity.
  
  
  CONCLUSIONS
  In patients with IGT, treatment with acarbose was associated with beneficial effects on 2-h plasma glucose levels but not with improvement of beta-cell function.
authors.affiliation: Department of General Practice, VU University Medical Centre, Amsterdam, Netherlands. g.nijpels@vumc.nl <g.nijpels@vumc.nl>
authors.forename: G
authors.initials: G
authors.lastname: Nijpels
authors.forename: W
authors.initials: W
authors.lastname: Boorsma
authors.forename: J M
authors.initials: JM
authors.lastname: Dekker
authors.forename: P J
authors.initials: PJ
authors.lastname: Kostense
authors.forename: L M
authors.initials: LM
authors.lastname: Bouter
authors.forename: R J
authors.initials: RJ
authors.lastname: Heine