title: MARCH2: comparative assessment of therapeutic effects of acarbose and metformin in newly diagnosed type 2 diabetes patients.
abstract: BACKGROUND
  The data of MARCH (Metformin and AcaRbose in Chinese as the initial Hypoglycaemic treatment) trial demonstrated that acarbose and metformin have similar efficacy as initial therapy for hemoglobin A1c (HbA1c) reduction in Chinese patients with newly diagnosed type 2 diabetes. We investigated whether the therapeutic efficacy was diversified under different body mass index (BMI) status.
  
  
  METHODS
  All 784 subjects were divided into normal-weight group (BMI<24 kg/m2), overweight group (BMI 24-28 kg/m2) and obese group (BMI≥28 kg/m2). Patients were assigned to 48 weeks of therapy with acarbose or metformin, respectively. The clinical trial registry number was ChiCTR-TRC-08000231.
  
  
  RESULTS
  The reduction of HbA1c levels and the proportion of patients with HbA1c of 6.5% or less were similar in the three groups after acarbose and metformin treatment. In overweight group, fasting blood glucose (FBG) after metformin treatment showed greater decline compared to acarbose group at 48 weeks [-1.73 (-1.99 to -1.46) vs. -1.37 (-1.61 to -1.12), P<0.05), however the decrease of 2 h post-challenge blood glucose (PBG) after acarbose treatment at 48 weeks was bigger compared to metformin group [-3.34 (-3.83 to-2.84) vs. -2.35 (-2.85 to -1.85), P<0.01]. Both acarbose and metformin treatment resulted in a significant decrease in waist circumference, hip circumference, weight and BMI in the three groups (all P<0.05).
  
  
  CONCLUSIONS
  Acarbose and metformin decreased HbA1c levels similarly regardless of BMI status of Chinese type 2 diabetic patients. Acarbose and metformin resulted in a significant and modest improvement of anthropometric parametres in different BMI status. Thus, acarbose treatment may contribute a similar effect on plasma glucose control compared to metformin, even in obesity patients.
  
  
  BACKGROUND
  ChiCTR.org ChiCTR-TRC-08000231.
authors.affiliation: Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, P. R. China.
authors.forename: Guang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, P. R. China.
authors.forename: Jia
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, P. R. China.
authors.forename: Ning
authors.initials: N
authors.lastname: Yang
authors.affiliation: Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, P. R. China.
authors.forename: Xia
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, P. R. China.
authors.forename: Hui
authors.initials: H
authors.lastname: Fan
authors.affiliation: Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, P. R. China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Endocrinology, China-Japan Friendship Hospital, Beijing, P. R. China.
authors.forename: Wenying
authors.initials: W
authors.lastname: Yang
mesh_terms: D020909:Acarbose / Q000008:administration & dosage*; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005215:Fasting / Q000097:blood; D065089:Glycoside Hydrolase Inhibitors / Q000008:administration & dosage*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D008687:Metformin; D020909:Acarbose