Effect of acarbose on vascular disease in patients with abnormal glucose tolerance

Cardiovasc Drugs Ther. 2008 Jun;22(3):225-31. doi: 10.1007/s10557-008-6091-1. Epub 2008 Feb 29.


Introduction: Excessive postprandial (pp) glucose excursion in people with IGT and type 2 diabetes is associated with a cascade of proatherogenic events. Acarbose, a potent competitive inhibitor of alpha-glucosidases of the small intestine specifically reduces pp hyperglycemia with an average reduction of HbA1c by 0.8% in Cochrane metaanalysis. This is associated with pleiotropic effects on a broad spectrum of cardiovascular (CV) risk factors: reduction of overweight, lowering of blood pressure, triglycerides, hsCRP, fibrinogen and other biomarkers of low grade inflammation.

Results and discussion: Flow mediated vasodilation was improved and progression of intima media thickness was reduced by acarbose. In the STOP-NIDDM trial in people with IGT acarbose decreased the incidence of diabetes by 36%. The STOP-NIDDM trial with CV events as secondary objective is the only intervention trial in people with IGT so far with a significant benefit for CV disease inclusive hypertension. In a metaanalysis of controlled studies (MeRIA) in patients with type 2 diabetes, treatment with acarbose was associated with a 64% lower rate of myocardial infarction and 35% less CV events.

Conclusion: Thus results so far available prove that acarbose is an effective and safe drug to treat abnormal glucose tolerance. They suggest that acarbose can help to control a broad spectrum of CV risk factors and may prevent CV disease.

Publication types

  • Review

MeSH terms

  • Acarbose / pharmacology
  • Acarbose / therapeutic use*
  • Animals
  • Blood Vessels / drug effects
  • Cardiovascular Diseases / chemically induced
  • Cardiovascular Diseases / pathology
  • Diabetes Mellitus, Type 2 / prevention & control
  • Glucose Intolerance / complications*
  • Glucose Intolerance / drug therapy*
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / drug therapy
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use*
  • Risk Factors
  • Vascular Diseases / etiology*
  • Vascular Diseases / prevention & control*


  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Acarbose