Acarbose: oral anti-diabetes drug with additional cardiovascular benefits

Expert Rev Cardiovasc Ther. 2008 Feb;6(2):153-63. doi: 10.1586/14779072.6.2.153.

Abstract

Acarbose is an alpha-glucosidase inhibitor acting specifically at the level of postprandial glucose excursion. This compound lowers HbA(1c) by 0.5-1% in patients with Type 2 diabetes, either drug naive or in combination with other antidiabetic drugs. In those with impaired glucose tolerance (IGT), it reduces the incidence of newly diagnosed diabetes by 36.4%. Furthermore, it has beneficial effects on overweight, reduces blood pressure and triglycerides, and downregulates biomarkers of low-grade inflammation. In the Study To Prevent Non-Insulin-Dependent-Diabetes-Mellitus (STOP-NIDDM) trial, acarbose significantly reduced the progression of intima media thickness, incidence of cardiovascular events and of newly diagnosed hypertension. In a meta-analysis of patients with Type 2 diabetes (MERIA), acarbose intake was associated with a reduction of cardiovascular events by 35%. Acarbose is a very safe drug but in approximately 30% of patients, it can cause gastrointestinal complaints due to its mode of action, which in the majority disappear after 1-2 months. Acarbose is approved for treatment of IGT in 25 countries. It can be given alone or in combination with other oral antidiabetics and insulin. Acarbose is particularly effective in those with IGT and early diabetes and patients with comorbidities of the metabolic syndrome.

Publication types

  • Review

MeSH terms

  • Acarbose / administration & dosage
  • Acarbose / adverse effects
  • Acarbose / therapeutic use*
  • Blood Vessels / diagnostic imaging
  • Blood Vessels / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus / diagnostic imaging
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / physiopathology
  • Diabetes Mellitus / prevention & control*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Disease Progression
  • Enzyme Inhibitors / administration & dosage
  • Enzyme Inhibitors / adverse effects
  • Enzyme Inhibitors / therapeutic use*
  • Gastrointestinal Diseases / chemically induced
  • Glucose Intolerance / diagnostic imaging
  • Glucose Intolerance / drug therapy
  • Glucose Intolerance / physiopathology
  • Glucosidases / antagonists & inhibitors
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Treatment Outcome
  • Ultrasonography

Substances

  • Enzyme Inhibitors
  • Hypoglycemic Agents
  • Glucosidases
  • Acarbose