Efficacy of α‐glucosidase inhibitors on lipids in NIDDM subjects with moderate hyperlipidaemia

Abstract

This paper summarizes literature data concerning the action of acarbose, an α‐glucosidase inhibitor, on the concentrations of plasma lipids. Clinical trials in which acarbose has been used in the treatment of non‐insulin‐dependent diabetics have sometimes shown that it reduces serum triglycerides while it has little or no effect on serum cholesterol levels. The results of a randomized double‐blind placebo‐controlled study lasting 24 weeks are discussed in more detail. Under the controlled conditions, the effects of acarbose treatment on fasting concentrations of cholesterol, HDL‐cholesterol, and triglycerides did not reach statistical significance for the entire patient group. However, in the highest tertile of initial cholesterol concentrations acarbose treatment led to significant lowering of the cholesterol concentration and of the total‐to‐HDL‐cholesterol ratio. The most important benefits of acarbose were observed after a test meal given on day 0 and on week 24 of treatment. The triglyceride increment 1 h postprandial was significantly lowered. This was associated by a significant decrease of the insulin increment. Reduction of hyperinsulinaemia appears to be the mechanism by which acarbose treatment can improve plasma lipid concentrations.

Acarbose: safe and effective for lowering postprandial hyperglycaemia and improving cardiovascular outcomes

“…Hanefeld et al 85 demonstrated, in a randomised, double-blind, placebo-controlled trial, that acarbose (100 mg three times daily) for 24 weeks as a first line therapy in patients with T2DM (n=94) reduced 1 h postprandial triglyceride levels. Another description by Leonhardt et al 86 showed that acarbose reduced total serum cholesterol and total-to-HDL-cholesterol ratio. Also, after a test meal on day 0 and on week 24 of acarbose treatment, there was a significantly lower postprandial rise in serum triglycerides.…”

“…Also, after a test meal on day 0 and on week 24 of acarbose treatment, there was a significantly lower postprandial rise in serum triglycerides. 86 …”

Pleiotropic effects of acarbose on atherosclerosis development in rabbits are mediated via upregulating AMPK signals

“…Previous clinical trials showed acarbose treatment can reduce elevated cholesterol concentrations in non-insulin dependent diabetics and non-diabetic patients1617. However, another clinical trial showed that in patients with non-insulin-dependent diabetes, acarbose reduces serum triglyceride levels without affecting serum cholesterol levels18. The anti-atherosclerotic mechanism of acarbose beyond glucose lowering is not fully understood.…”

Effect of Acarbose on Vascular Disease in Patients with Abnormal Glucose Tolerance

“…With respect to lipids the major effect is on fasting and pp triglycerides with a reduction of about 15% [39,40]. In addition acarbose reduces atherogenicity of low density lipoproteins in people with IGT [41].…”