title: A prospective, randomized, open-label study comparing the efficacy and safety of preprandial and prandial insulin in combination with acarbose in elderly, insulin-requiring patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  By delaying absorption of carbohydrates, acarbose can reduce preprandial hyperglycemia and delay the emergence of postprandial hyperglycemia.
  
  
  METHODS
  To evaluate whether acarbose can shorten the desirable time interval between insulin injection and meals, 60 elderly (≥60 years) patients with unsatisfactorily controlled type 2 diabetes mellitus despite insulin use were enrolled in a randomized, open-label study of 16 weeks' duration. Two groups (n=20 each) were randomized to receive isophane protamine biosynthetic human insulin 70/30 injections twice daily 30 min before meals plus acarbose 50 mg once daily (Group A) or three times daily (Group B) before meals, whereas the third group (n=20) received isophane protamine biosynthetic human insulin 70/30 injections twice daily immediately before meals plus acarbose 50 mg three times daily before meals (Group C).
  
  
  RESULTS
  The required insulin dosage at study end was significantly less in Groups B and C than in Group A. Both continuous glucose monitoring data and the patients' self-monitoring data indicated that blood glucose variability parameters were significantly improved in Groups B and C in comparison with Group A, but there were no significant differences between Groups B and C. The incidence of hypoglycemia was low in all three groups.
  
  
  CONCLUSIONS
  The absence of a significant difference in glucose variability between Groups B and C suggests that the addition of acarbose permitted adjustment of the insulin administration time from 30 min before meals to immediately before meals-which may be more convenient for patients-without affecting glycemic control.
authors.affiliation: Department of Geriatric Endocrinology, Chinese PLA General Hospital, 100853 Beijing, China.
authors.forename: Guang
authors.initials: G
authors.lastname: Yang
authors.forename: Chunlin
authors.initials: C
authors.lastname: Li
authors.forename: Yanping
authors.initials: Y
authors.lastname: Gong
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Cheng
authors.forename: Hui
authors.initials: H
authors.lastname: Tian
mesh_terms: D020909:Acarbose / Q000627:therapeutic use*; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004040:Dietary Carbohydrates; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D020909:Acarbose; D001786:Blood Glucose; D004040:Dietary Carbohydrates; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human