title: Acarbose Monotherapy and Type 2 Diabetes Prevention in Eastern and Western Prediabetes: An Ethnicity-specific Meta-analysis.
abstract: OBJECTIVE
  Acarbose is effective in delaying or preventing the progression of prediabetes to type 2 diabetes mellitus (T2DM). The aim of this study was to assess differences in the preventive effects of acarbose in Eastern and Western populations with prediabetes.
  
  
  METHODS
  We performed a systematic search of databases and reference lists of clinical trials conducted through August 2013. Randomized controlled trials of acarbose alone, with a minimum intervention duration of 3 years and which provided data on T2DM incidence, were included for analysis. Analyses were conducted by using Review Manager version 5.1 software.
  
  
  RESULTS
  Eight randomized controlled trials with 2628 participants were included. Acarbose decreased the occurrence of T2DM (number needed to treat [NNT], 6.7). Compared with the control (placebo and/or lifestyle intervention), the incidence of T2DM was significantly lower in the Eastern group (NNT, 5.9) than in the Western group (NNT, 11.1) (P < 0.0001, I(2) = 94.7%). At the end of follow-up, reversal of prediabetes to normal glucose tolerance was more likely in the Eastern group (NNT, 4.3) than in the Western group (NNT, 25) (P = 0.004, I(2) = 92%). Among those remaining prediabetic, there was no significant difference between the subtotal estimates for the subgroups (P = 0.17, I(2) = 46.5%). There was no positive correlation between preventive effect and dose, and no difference in studies with varying follow-up durations within and across either ethnic group.
  
  
  CONCLUSIONS
  The preventive effect of acarbose on the development of diabetes seems superior in Eastern populations with prediabetes compared with Western populations.
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Ruijie
authors.initials: R
authors.lastname: Hu
authors.affiliation: Department of Endocrinology, Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Qingguo
authors.initials: Q
authors.lastname: Lv
authors.affiliation: Chinese Cochrane Centre, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Taixiang
authors.initials: T
authors.lastname: Wu
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China. Electronic address: buddyjun@hotmail.com.
authors.forename: Nanwei
authors.initials: N
authors.lastname: Tong
mesh_terms: D020909:Acarbose / Q000627:therapeutic use*; D001208:Asia / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control*; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D065089:Glycoside Hydrolase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008019:Life Style; D009656:North America / Q000453:epidemiology; D011236:Prediabetic State / Q000188:drug therapy* / Q000208:ethnology
chemical_list: D065089:Glycoside Hydrolase Inhibitors; D020909:Acarbose
keywords: acarbose; diabetes prevention; ethnicity; prediabetes