ACARBOSE CONTROLS POSTPRANDIAL HYPERPROINSULINEMIA IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS

We investigated how fasting or postprandial insulin levels were altere d by treatment with acarbose or sulfonylureas. Plasma glucose and seru m insulin, C-peptide, and proinsulin levels were measured before as we ll as 1 and 2 h after breakfast in 23 patients with non-insulin-depend ent diabetes mellitus and 17 patients with impaired glucose tolerance. In the diabetic patients, 12 weeks of acarbose therapy decreased the postprandial levels of glucose (1 h: -60.0%; 2 h: -67.6%), insulin (1 h: -67.5%; 2 h: -72.2%) and proinsulin (1 h: -55.2%; 2 h: -46.7%), and proinsulin (1 h: -20.9%; 2 h: -57.5%). In contrast, sulfonylurea trea tment increased postprandial insulin and proinsulin levels. Since incr eased in the serum insulin or proinsulin levels are associated with a higher risk of cardiovascular disease, the present findings suggest th at the acarbose-induced reduction of the postprandial serum insulin or proinsulin responses to food intake might be useful for preventing va scular complications in patients with diabetes. (C) 1997 Elsevier Scie nce Ireland Ltd.