Low-dose Acarbose Research Articles

The efficacy and tolerability of intermittent prandial acarbose to reduce glucose spikes in healthy individuals

Acarbose is an α-glucosidase inhibitor that slows the digestion of carbohydrates and can prevent sharp increases in blood sugar levels after meals (spikes). Excessive postprandial blood glucose spikes have been associated with chronic conditions, increase all-cause mortality, and may contribute to aging. Therefore, the prevention of glucose spikes may contribute to the preservation of human healthspan. Indeed, acarbose has been associated with increased lifespan in animal models. However, its tolerability profile has limited acarbose use in healthy individuals. We hypothesized that using low-dose acarbose right before the occasional high-carbohydrate meal may prevent glucose spikes in healthy individuals. We performed a prospective clinical study to evaluate the tolerability and efficacy of acarbose in healthy individuals. Participants were randomized into two arms, each performing two control tests and two treatment tests. Continuous glucose monitor (CGM) measurements were collected for 2 h after high carbohydrate meals with or without pre-meal 50 mg acarbose intake. Tolerability was assessed using questionnaires. Twelve patients had evaluable results. Acarbose pretreatment resulted in reductions in CGM glucose measurements, with a significant decrease in glucose levels at the start, after 15 min, and at peak glucose levels. Few participants reported acarbose adverse events, and these included flatulence, bloating, nausea, abdominal pain, and stomach aches. No statistical difference in tolerability was detected between periods with and without acarbose. In conclusion, treatment with 50 mg of acarbose before meals was found to be well tolerated and efficacious in blunting the postprandial glucose spike by over 17% in healthy individuals.

Sargassum fusiforme polysaccharide partly replaces acarbose against type 2 diabetes in rats

The objective of present research was to explore whether Sargassum fusiforme polysaccharide (SFP) could partly replace acarbose against type 2 diabetes in rats. Results indicated that SFP co-administered with low-dose acarbose intervention typically mitigated diabetic symptoms and serum profiles and exhibited better anti-diabetic effects than single acarbose treatment in controlling fasting blood glucose, improving insulin resistance and mitigating kidney injuries. The RT-qPCR analysis indicated that SFP co-administered with low-dose acarbose administration distinctly activated the IRS/PI3K/AKT signaling pathway compared with single acarbose treatment. Moreover, the co-administration also restrained liver fat accumulation via affecting the expression of HMGCR and SREBP-1c genes. In addition, the 16S rRNA gene sequencing analysis indicated that SFP co-administered with low-dose acarbose significantly restored beneficial composition of gut flora in diabetic rats, such as the increase of Muribaculaceae, Lachnospiraceae, Bifidobacterium, Ruminococcaceae_UCG-014, Ruminococcus_1, Romboutsia, Eggerthellaceae, Alistipes and Faecalibaculum, and the decrease of Escherichia-Shigella. These results suggested that SFP, the novel natural adjuvant of acarbose, displayed the desirable benefits in minimizing the dose of drug, while improving the anti-diabetic efficiency.

Low-dose acarbose appears to reduce cardiovascular risk factors in obese patients with polycystic ovary syndrome (PCOS),

Low-dose acarbose appears to reduce cardiovascular risk factors in obese patients with polycystic ovary syndrome (PCOS),

Postprandial Reactive Hypoglycemia in an Oldest-old Patient Effectively Treated with Low-dose Acarbose

We recently encountered a 96-year-old Japanese woman who suffered from frequent hypoglycemia. Endocrinological and imaging data eliminated the possibility of insulinoma, whereas oral glucose tolerance testing revealed impaired glucose tolerance and subsequent reactive hypoglycemia. The patterns between insulin or C-peptide secretions and glucose excursions demonstrated that the discrepancy occurred in the late postprandial stage. Administration of small doses of alpha-glucosidase inhibitor (alpha-GI) dramatically inhibited the rapid rise and subsequent precipitous fall of plasma glucose. Reactive hypoglycemia may be one of the important cause of hypoglycemia in the elderly, and alpha-GI could effectively and safely prevent such hypoglycemic attacks in those patients.

Acarbose in obese patients with polycystic ovarian syndrome: a double-blind, randomized, placebo-controlled study

The present study assessed the effects of low-dose acarbose on obese patients with polycystic ovarian syndrome (PCOS). A double-blind placebo-controlled study was conducted on 30 obese hyperinsulinaemic women with PCOS treated with 150 mg/day acarbose or placebo for 6 months. The women were evaluated for hirsutism, menstrual regularity, body mass index (BMI), insulin resistance and glucose tolerance, sex hormone-binding globulin (SHBG), LH, FSH, testosterone and androstenedione, and side-effects. The patients in the acarbose group showed a reduction in BMI (35.87 +/- 2.60 versus 33.10 +/- 2.94 kg/m(2)) and in the Ferriman-Gallwey index (8.85 +/- 2.31 versus 8 +/- 1.82), and an increased chance of menstrual regularity (rate = 2.67). SHBG concentration increased (21.01 +/- 7.9 versus 23.85 +/- 7.77 nmol/l) and the free androgen index was reduced (14.81 +/- 9.06 versus 11.48 +/- 6.18). None of these parameters were modified in the placebo group. Mild side-effects occurred in 84% of the patients in the acarbose group and disappeared after the first 3 months. A low dose of acarbose administered to obese patients with PCOS promotes a reduction in free androgen index and BMI and an increase in SHBG, with improvement of hirsutism and of the menstrual pattern, and is well tolerated by patients.

Secretion of GIP in responders to acarbose in obese Type 2(NIDDM) patients

Acarbose has been shown to reduce postprandial hyperglycemia and to improve lipid parameters in diabetics via its inhibitory effects on intestinal α-glucosidases. Response to acarbose may therefore be dependent upon gastric or pancreatic hormone function. To test this hypothesis, we treated 27 mild type 2 (NIDDM) Japanese diabetics who were mildly obese with low-dose acarbose (150 mg/day) for 3 months. We then performed a responder analysis to determine specific hormonal responses that may be associated with a good response to acarbose. At the end of the treatment period, a total of 15 evaluable patients was grouped as responders ( n=6) and nonresponders ( n=9) based on an effective decrease in postprandial glucose levels (>30 mg/day) and glycosylated hemoglobin (HbA1c) levels (>0.5%). There were no differences between the two groups in demographic variables or mean postprandial glucose levels at baseline. There was a small but significant increase in postprandial cholecystokinin (CCK) in responders, and fasting gastric inhibitory peptide (GIP) levels were significantly increased in responders and all patients after treatment. Serum leptin levels were reduced by treatment in our mildly obese responders and this was associated with a significant decrease in body weight. These results suggest that treatment with low-dose acarbose may reduce hyperglycemia in mild type 2 Japanese patients and may improve metabolic control by regulating hormones involved in glycemic control and digestive absorption. Acarbose may provide a safe adjunct to help treat insulin resistance in type 2 patients.