Abstract
Background and Aims. To evaluate the effect of adding acarbose on glycemic excursions measured by continuous glucose monitoring system (CGMS) in patients with type 2 diabetes mellitus (T2DM) already on insulin therapy. Materials and Methods. This was an opened and unblended study. 134 patients with T2DM were recruited. After initial rapidly corrected hyperglycaemia by continuous subcutaneous insulin infusion (CSII) for 7 d, a 4–6-day premixed insulin titration period subsequently followed. Patients were then randomized 1 : 1 to acarbose plus insulin group or insulin therapy group for 2 weeks. CGMS was used to measure glucose fluctuations for at least 3 days after therapy cessation. Results. Patients in acarbose plus insulin group achieved a significant improvement of MAGE compared to that of insulin therapy only group (5.56 ± 2.16 versus 7.50 ± 3.28 mmol/L, P = 0.044), accompanied by a significant decrease in the incremental AUC of plasma glucose concentration above 10.0 mmol/L (0.5 [0.03, 0.9] versus 0.85 [0.23,1.4] mmol/L per day, P = 0.037). Conclusions. Add-on acarbose to insulin therapy further improves glucose fluctuation in patients with T2DM. This study was registered with ClinicalTrials.gov registration number ChiCTR-TRC-11001218.
Highlights
Received wisdom indicated that acarbose could improve mean haemoglobin A1c (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM) by reducing plasma glucose concentration [1, 2]
The mean amplitude of glycemic excursions (MAGE) measured by continuous glucose monitoring system (CGMS) in the group of diabetes patients treated with insulin alone (7.50 ± 3.28 mmol/L) was significantly higher than the group with added acarbose (5.56 ± 2.16 mmol/L, P = 0.044, Figure 1)
We observed that the addition of acarbose to insulin improves glucose fluctuation in patients with T2DM, as measured by MAGE, and reduced the risk of severe hypoglycemia
Summary
Received wisdom indicated that acarbose could improve mean haemoglobin A1c (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM) by reducing plasma glucose concentration [1, 2]. Studies have demonstrated that acarbose was effective in reducing postprandial glycemic excursions [8]; combined administration of acarbose with alogliptin therapy resulted in decreasing plasma glucose fluctuations [9]. To evaluate the effect of adding acarbose on glycemic excursions measured by continuous glucose monitoring system (CGMS) in patients with type 2 diabetes mellitus (T2DM) already on insulin therapy. Patients in acarbose plus insulin group achieved a significant improvement of MAGE compared to that of insulin therapy only group (5.56 ± 2.16 versus 7.50 ± 3.28 mmol/L, P = 0.044), accompanied by a significant decrease in the incremental AUC of plasma glucose concentration above 10.0 mmol/L (0.5 [0.03, 0.9] versus 0.85 [0.23, 1.4] mmol/L per day, P = 0.037). This study was registered with ClinicalTrials.gov registration number ChiCTR-TRC-11001218
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