Effects of Acarbose in Metabolic Control of Patients

carbose is a reversible inhibitor of the intestinal alpha-glucosidases, the oral administration of which delays absorption of carbohydrates. The aim of this study was to investigate the effect of administration of acarbose on parameters of glycaemic control, lipid parameters and tolerability in ambulant type 1 diabetic subjects. Materials and Methods: Entry criteria included being: diabetic, age below 30 years and a history of at least one episode of diabetic ketoacidosis insufficiently controlled with diet and insulin. The data of 17 patients (6 men and 11 women, mean age 17.2±3.5 (range 14–26) years, median duration of diabetes 8 (range 1–20) years were valid for statistical analysis. Results: During the run-in period HbA1c levels tended to decrease from 9.5±1.1 to 9±1.7%. After 12 weeks of acarbose treatment, the mean level had decreased further to 7.6±1.6% (P: 0.002). After discontionuing acarbose, HbA1c levels increased to a mean level of 8.8±0.9%. A significant reduction in Fasting Plasma Glucose (FPG) (from 195±62 to 139±73 mg/dL, P<0.01) and 2 hour post prandial glucose (2 hppG) was observed with acarbose (from 231±82 to 159±72 mg/dL, P<0.001). Reduction in total cholesterol (from 159±36 to 146±26 mg/dL, p: 0.09) and triglycerides (from100±22 to 81±23 mg/dL, p: 0.02) was detected after treatment with acarbose. No significant changes were observed in HDL cholesterol. The most frequent reported adverse events were flatulence (7 subjects) and mild abdominal pain (2 subjects). Conclusion: We conclude that acarbose up to 3×100 mg/day can be a valuable adjunct to insulin in improving metabolic control in persons with type 1 diabetes