THE EFFECT OF ACARBOSE ON INSULIN SENSITIVITY IN SUBJECTS WITH IMPAIRED GLUCOSE-TOLERANCE

Acarbose is an alpha-glucosidase inhibitor which delays the absorption of glucose from the intestine. Taken orally before a meal, acarbose d elays absorption of carbohydrates and decreases the postprandial plasm a glucose and plasma insulin rise. A pilot study has been carried out to investigate whether acarbose can improve insulin sensitivity in sub jects with impaired glucose tolerance (IGT). 18 subjects were randomiz ed to receive either acarbose, 100 mg t.d.s., or placebo for 16 weeks. Acarbose therapy was found to decrease 2-hour plasma glucose and plas ma insulin levels and to increase insulin sensitivity. Insulin resista nce is an important factor in the development of non-insulin dependent diabetes mellitus (NIDDM). These results suggest that acarbose therap y may be able to prevent or delay the progression of IGT to NIDDM. A m ulticentre phase III clinical trial is now planned to investigate this possibility.