Effects of the treatment with acarbose in elderly overweight type 2 diabetic patients in poor glycemic control with oral hypoglycemic agents or insulin

The aim of this study was to evaluate the efficacy of acarbose, an inhibito r of alpha-glucosidase, on glycemic control in elderly overweight type 2 di abetic patients poorly controlled by oral hypoglycemic agents (OHA) or insu lin. Our study included 22 overweight patients, 60-75-years-old, treated wi th OHA and/or insulin who, after a period of 4 weeks of controlled diet, sh owed a poor metabolic control. They were divided into two groups: Group I ( nine patients) on OHA treatment; Group II (13 patients) undergoing treatmen t with insulin alone or in combination with OHA. Acarbose was administered to all the patients (100 mg three times a day at meal times) for 6 months i n addition to their previous treatment. The addition of acarbose caused a s ignificant reduction in both groups with regard to fasting glycemia (after 3 and 6 months, respectively, 20.7 and 21.9%, P < 0.04 in Group I; 19.1 and 21.8%, P < 0.04 in Group II), and postprandial glycemia (after 3 and 6 mon ths, respectively, 41.6 and 42.5%, P < 0.0001 in Group I; 35.6 and 38%, P < 0.0006 in Group II). There was also a significant reduction in the values of HBA(1c) in Group I after 6 months of treatment (24.3%, P < 0.05) and in Group II after 3 and 6 months (respectively 13.4%, P < 0.02 and 20.6%, P < 0.01). Three months after treatment with acarbose ended, fasting and postpr andial glycemia and HBA(1c) values returned to original baseline values. In conclusion, the addition of acarbose to the OHA in elderly overweight type 2 diabetic patients poorly controlled by OHA or insulin regimes improved m etabolic control. (C) 2000 Published by Elsevier Science Ireland Ltd.