THE EFFECT OF THE TIMING AND THE ADMINISTRATION OF ACARBOSE ON POSTPRANDIAL HYPERGLYCEMIA

To clarify the optimum timing for ingestion of acarbose, a 100 mg dose of this oral hypoglycaemic agent was administered 30 min before, at t he beginning, and 15 min after ingestion of a test meal, and the effec ts of the drug on blood glucose rises were compared with increases obs erved after a control meal (no drug). Twenty-four patients with Type 2 diabetes were included in a randomized, open, cross-over study. The s mallest increases in blood glucose (p < 0.001) occurred when acarbose was taken at the beginning and 15 min after starting the test meal (3. 3 +/- 1.6 mmol l(-1) and 3.3 +/- 1.4 mmol l(-1)). The increase in bloo d glucose levels when acarbose was taken 30 min before the test meal w as significantly higher (4.2 +/- 1.8 mmol l(-1)) and it was at its max imum following the control meal (5.2 +/- 1.7 mmol l(-1)). Similar resu lts were observed when the effects of acarbose on insulin and C-peptid e levels were measured. It is recommended that patients should be inst ructed to take acarbose with their first mouthful of food.