title: Acarbose plus metformin fixed-dose combination outperforms acarbose monotherapy for type 2 diabetes.
abstract: OBJECTIVE
  To compare the efficacy and safety of acarbose plus metformin fixed-dose combination (FDC) versus acarbose monotherapy for type 2 diabetes (T2D).
  
  
  METHODS
  Eligible T2D patients undergoing treatment with diet control only or oral antidiabetic medications were run-in on acarbose 50mg thrice-daily for 4 weeks, then randomised either to continue this monotherapy, or to acarbose 50mg plus metformin hydrochloride 500mg FDC (acarbose/metformin FDC), each thrice-daily for 16 weeks.
  
  
  RESULTS
  Acarbose/metformin FDC therapy significantly reduced HbA1c, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) from baseline (all p<0.0001) with superior efficacy compared with acarbose monotherapy (between-group differences; HbA1c -1.35%; FPG -29.5mg/dl; PPG -41.6mg/dl; all p<0.0001). Proportionally more patients treated with acarbose/metformin FDC achieved HbA1c <7.0% (47.8% vs. 10.7%, p<0.0001). Both treatments reduced bodyweight (p<0.0001), with a significant between-group difference (-0.6kg, p<0.01) favouring acarbose/metformin FDC. Hypoglycaemia was not reported with either treatment, and the incidence of other adverse events did not differ significantly between the groups.
  
  
  CONCLUSIONS
  Compared with acarbose monotherapy, acarbose/metformin FDC has superior antihyperglycaemic efficacy, brings proportionally more T2D patients to HbA1c goal, and further reduces bodyweight. Acarbose/metformin FDC is well-tolerated without significant risk of hypoglycaemia and is a potentially advantageous therapy for T2D.
authors.affiliation: Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Jun-Sing
authors.initials: JS
authors.lastname: Wang
authors.forename: Chien-Ning
authors.initials: CN
authors.lastname: Huang
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Hung
authors.forename: Ching-Fai
authors.initials: CF
authors.lastname: Kwok
authors.forename: Jui-Hung
authors.initials: JH
authors.lastname: Sun
authors.forename: Dee
authors.initials: D
authors.lastname: Pei
authors.forename: Chwen-Yi
authors.initials: CY
authors.lastname: Yang
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Chen
authors.forename: Ching-Ling
authors.initials: CL
authors.lastname: Lin
authors.forename: Wayne Huey-Herng
authors.initials: WH
authors.lastname: Sheu
mesh_terms: D020909:Acarbose / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004338:Drug Combinations; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D020909:Acarbose; D001786:Blood Glucose; D004338:Drug Combinations; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin
keywords: Alpha-glucosidase inhibitor; Combination; Diabetes; Glycaemic control; Metformin