Long-term treatment in diabetics with acarbose, a glucosidase inhibitor: efficacy, tolerability and effect on GI hormones.

12 months therapy with acarbose in 143 type I and type II patients markedly improved the metabolic control, assessed by fasting and postprandial blood glucose determination. During 5 year acarbose treatment GIP levels were decreased and enteroglucagon levels were elevated. After withdrawal of the drug for one week GIP levels increased and enteroglucagon concentrations fell. Thus, GI-hormone changes were reversible after discontinuation of acarbose. Tolerability of acarbose was good and clinical chemistry and haematology parameters showed no changes after 1-5 years acarbose therapy. Approximately 60% of the patients had intestinal symptoms which subsided again for most patients after 1-4 weeks therapy with acarbose. Body weight remained unchanged. The glucosidase inhibitor acarbose is a new effective and safe therapeutic concept in the treatment of diabetes mellitus.