Acarbose improves glycemic control and reduces body weight: Subanalysis data of South Asia region

Abstract

Alpha-glucosidase inhibitors (AGIs) are widely used especially in Asian countries as a treatment option for type 2 diabetes patients with high postprandial glycaemia. However, data from South Asia region is very limited. In order to examine the effect of AGI in real-life setting, 10 PMS/NIS from all over the world from the launch of acarbose to date were pooled in one database and exploratory analysis was performed for glycemic parameters and weight. In total 62,905 patients were pooled from 21 countries and regions. Mean follow up (± SD) was 12.2 ± 4.8 weeks (range 0.1-108.9). From South Asia region (India and Pakistan), 8,738 Asian patients were enrolled. Mean PPG decreased from 240.0 and 261.1 mg/dl at baseline by 70.26 ± 65.10 and 82.96 ± 56.59 mg/dl at the last visit in total and South Asian populations, respectively (n = 53,883; n = 7,991, P < 0.0001 for both). Mean FPG decreased from 171.6 and 176.5 mg/dl at baseline by 38.48 ± 47.83 and 49.59 ± 41.41 mg/dl at the last visit in total and South Asian populations, respectively (n = 56,672; n = 7,837, P < 0.0001 for both). Mean HbA1c decreased from 8.4 and 8.4% at baseline by 1.11 ± 1.31% and 0.91 ± 0.93% at the last visit in total and South Asian populations, respectively (n = 38,843; n = 2,343, P < 0.0001 for both). Mean relative reduction of body weight (BW) was 1.40 ± 3.28% and 1.10 ± 3.39% at the last visit for mean baseline BW 73.6 and 74.2 kg in total and South Asian populations, respectively (n = 54,760; n = 7,718, P < 0.0001 for both). Consistent with RCT meta-analyses, post-hoc analysis of real-life data showed acarbose treatment improved glycaemic control and reduced the BW. Acarbose treatment in real life setting showed significant reductions in all glycemic parameters and BW in Asian patients from South Asia region.

Effects of a novel combination of orlistat and acarbose on tolerability, appetite, and glucose metabolism in persons with obesity

“…Acarbose delays carbohydrate digestion in the GI tract and reduces the subsequent intestinal glucose absorption rate . On its own, acarbose has also been shown to have a small effect on weight loss; however, acarbose treatment in its conventional oral dosage forms is associated with frequent (~3‐30% of patients) GI side‐effects, mainly flatulence and sometimes soft stools or abdominal discomfort …”

Therapeutic potential of α-glucosidase inhibitors in type 2 diabetes mellitus: an evidence-based review

“…Further, acarbose is superior in decreasing body weight when compared with placebo (-1. 15 [133] and South Asian region [134] support the observation of more pronounced weight reduction in Eastern populations than in Western populations with hyperglycemia [135]. Further, acarbose in combination with metformin [15,91] and SU [136] also reduces weight gain.…”

Treatment Options for Patients with Type 2 Diabetes Mellitus during the Fasting Month of Ramadan

“…However, in a non-fasting group, it is associated with low hypoglycaemic risks with the added benefit of mild weight loss, absent cardiovascular sequelae with modest HbA1c reduction of 0.4-0.6%. [15][16][17][18][19] It may, however, be limited by its gastrointestinal side effects, especially after a heavy carbohydrate intake seen during the breaking of fast. [20][21][22] On the other hand, the twicedaily dosing during Ramadan (with the omission of lunch dose) may reduce its gastrointestinal side effects, which are dose-dependent.…”