糖尿病患者に対するアカルボース投与時の糖脂質代謝変動と服薬説明

Abstract

The effects of an α-glucosidase inhibitor, acarbose on serum lipoproteins as well as hemoglobin A1c were studied in type 2 diabetes mellitus patients. Furthermore, the improving rates of hemoglobin A1c and serum lipoproteins were compared between the patients with and those without patient-counseling by a pharmacist.Acarbose was administered to 55 poor control type 2 diabetes mellitus patients for 4 months. Overall, the level of HbA1c was reduced by 1.55%. The reduction in patients with patient counseling (PC, n=17) was 2.1% while that in patients without such counseling (non-PC, n=38) was 1.05%(p<0.01). Total cholesterol and triglyceride levels were reduced in total by 7.7%, 21.8%, respectively, but the rate of decrease was significantly larger in PC than in non-PC patients (8.8% vs 5.3% for total cholesterol, 29.3% vs 10.1% for triglyceride, both p< 0.001). The Midband, which migrated between VLDL and LDL on polyacrylamide disc electrophoresis disappeared in 45% of the patients, and the Midband of PC disappeared in 60% of the patients, whereas the same rate for non-PC was 35%.These results suggested that the delayed glucose absorption by acarbose in type 2 diabetes mellitus improved the serum lipoproteins as well as the blood glucose level, and that patient counseling by a pharmacist significantly improved the efficacy of this agent.