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 alp ha -glucosidases. Response to acarbose may therefore be dependent upon gast ric 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 ev aluable patients was grouped as responders (n=6) and nonresponders (n=9) ba sed on an effective decrease in postprandial glucose levels (>30 mg/day) an d glycosylated hemoglobin (HbA1c) levels (>0.5%). There were no differences between the two groups in demographic variables or mean postprandial gluco se levels at baseline. There was a small but significant increase in postpr andial cholecystokinin (CCK) in responders, and fasting gastric inhibitory peptide (GIP) levels were significantly increased in responders and all pat ients after treatment. Serum leptin levels were reduced by treatment in our mildly obese responders and this was associated with a significant decreas e in body weight. These results suggest that treatment with low-dose acarbo se may reduce hyperglycemia in mild type 2 Japanese patients and may improv e metabolic control by regulating hormones involved in glycemic control and digestive absorption. Acarbose may provide a safe adjunct to help treat in sulin resistance in type 2 patients. (C) 2001 Elsevier Science Inc. All rig hts reserved.