In a nutshell
The authors aimed to compare the effectiveness and safety of acarbose (Precose) used with or without metformin (Glucophage) in patients with type 2 diabetes.
Some background
Type 2 diabetes is a long-term progressive disease that occurs due to resistance to insulin which causes high blood glucose (sugar). There are several drugs used to treat this disease and to slow down its progression, out of which the most widely used is metformin (an oral drug that suppresses glucose production by the liver). Metformin is often combined with acarbose (slows the appearance of sugar in the blood following a meal) in an effort to control blood glucose. Acarbose is also used in many countries for prediabetes (elevated blood glucose levels). The effectiveness of these drugs can be evaluated by using HbA1c levels, which are a measurement of average blood glucose over the past 3 months. The target HbA1c is level is <7%.
Methods & findings
The study looked at 233 patients in total over a period of 16 weeks. The patients were first placed on a 4 week treatment with acarbose alone. Then, 116 continued with the acarbose therapy while 117 had metformin added to their regimen. The study then compared HbA1c measurements taken at the beginning of the study to those taken at the end to evaluate the effectiveness of either treatment.
It was found that a higher number of patients taking acarbose/metformin reached their HbA1c goal (47.8%) than patients on acarbose alone (10.7%). It also found that both treatments reduced body weight with more weight loss in patients on acarbose/metformin as well as reduced fasting plasma glucose levels (levels of glucose in the blood after several hours without food). Neither group had any significant difference in side effects nor had any hypoglycemic episodes.
The bottom line
The study concluded that acarbose/metformin combination is well tolerated without significant side effects and is more effective therapy for type 2 diabetes compared to acarbose alone.
The fine print
The acarbose group had a significant number of drop outs due to elevated fasting plasma glucose levels. These patients were not used in the final analysis, which can impact the results.
What’s next?
If unable to control your diabetes with acarbose alone, consult with your doctor about adding metformin to your regimen.
Published By :
Diabetes Research and Clinical Practice
Date :
Sep 25, 2013
