Beneficial metabolic effects of nateglinide versus acarbose in patients with newly-diagnosed type 2 diabetes

Acta Pharmacol Sin. 2007 Apr;28(4):534-9. doi: 10.1111/j.1745-7254.2007.00534.x.


Aim: To investigate the acute and chronic effects of nateglinide versus acarbose on plasma asymmetric dimethylarginine (ADMA) levels and lipid profiles in patients with newly-diagnosed type 2 diabetes.

Methods: A crossover trial of nateglinide and acarbose was conducted on 16 drug-naïve patients with newly-diagnosed type 2 diabetes during a total period of 9 weeks. Plasma glucose, serum insulin, free fatty acids (FFA), lipids and lipoproteins, and plasma ADMA were measured.

Results: The efficiencies of a single dose of nateglinide (120 mg) and acarbose (50 mg) for lowering postprandial hyperglycemia were similar. Compared to acarbose, nateglinide significantly increased postprandial insulin release after a standard meal test in patients with type 2 diabetes. Nateglinide acutely decreased postprandial 120 min FFA concentrations and 240 min ADMA levels more significantly than acarbose. The fasting high-density lipoprotein cholesterol level increased and the low-density lipoprotein cholesterol level decreased significantly, but the fasting levels of triglycerides, total cholesterol, and ADMA were unchanged after 4 weeks of treatment with nateglinide. Acarbose did not affect fasting lipid profiles or the ADMA levels after 4 weeks of treatment.

Conclusion: These results suggest that the reduction of postprandial FFA and ADMA concentrations induced by nateglinide may be associated with the partial restoration of early-phase insulin secretion and may impart a cardiovascular advantage in comparison with acarbose.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acarbose / therapeutic use*
  • Arginine / analogs & derivatives
  • Arginine / blood
  • Blood Glucose / metabolism
  • Cross-Over Studies
  • Cyclohexanes / therapeutic use*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / blood
  • Lipids / blood
  • Male
  • Middle Aged
  • Nateglinide
  • Phenylalanine / analogs & derivatives*
  • Phenylalanine / therapeutic use
  • Prospective Studies


  • Blood Glucose
  • Cyclohexanes
  • Hypoglycemic Agents
  • Insulin
  • Lipids
  • Nateglinide
  • Phenylalanine
  • N,N-dimethylarginine
  • Arginine
  • Acarbose