Influence of treatment with acarbose or glibenclamide on insulin sensitivity in type 2 diabetic patients

Fischer, Sabine; Patzak, Andreas; Rietzsch, Hannes; Schwanebeck, Uta; Köhler, Christof; Wildbrett, J.; Fuecker, Katja; Temelkova‐Kurktschiev, Theodora; Hanefeld, Markolf

doi:10.1046/j.1463-1326.2003.00239.x

Cited by 32 publications

(26 citation statements)

References 30 publications

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“…However, these effects do not influence total energy intake or diet nutrition composition, and no body weight loss has been observed in subjects treated with acarbose (30). Acarbose treatment improved glycemic control and insulin sensitivity without a change in postprandial insulin increment or body weight loss during a 16-week treatment study (31). Acarbose is used as an adjuvant therapy with other diabetes agents, which implies more advanced diabetic conditions and yields a higher aDCSI score than in those who do not use acarbose.…”

Section: Discussionmentioning

confidence: 96%

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

et al. 2015

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OBJECTIVEAcarbose, an a-glucosidase inhibitor, has been shown to have antineoplastic effects on colorectal cancer in biomarker studies. We assessed the association between acarbose use in patients with diabetes and incident colorectal cancer. RESEARCH DESIGN AND METHODSWe conducted a nationwide, population-based study using a large cohort with diabetes in the Taiwan National Health Insurance Research Database. Patients with newly diagnosed diabetes (n = 1,343,484) were enrolled between 1998 and 2010. One control subject not using acarbose was randomly selected for each subject using acarbose after matching for age, sex, diabetes onset, and comorbidities. Cox proportional hazards regression with a competing risks analysis was used to calculate the hazard ratios (HRs) and 95% CIs for the association between acarbose use and incident colorectal cancer for each eligible case-control pair (n = 199,296). RESULTSThere were 1,332 incident cases of colorectal cancer in the cohort with diabetes during the follow-up period of 1,487,136 person-years. The overall incidence rate was 89.6 cases per 100,000 person-years. Patients treated with acarbose had a 27% reduction in the risk of colorectal cancer compared with control subjects. The adjusted HRs were 0.73 (95% CI 0.63-0.83), 0.69 (0.59-0.82), and 0.46 (0.37-0.58) for patients using >0 to <90, 90 to 364, and ‡365 cumulative defined daily doses of acarbose, respectively, compared with subjects who did not use acarbose (P for trend < 0.001). CONCLUSIONSAcarbose use reduced the risk of incident colorectal cancer in patients with diabetes in a dose-dependent manner.Colorectal cancer is one of the most common cancers worldwide (1), causing an estimated 694,000 deaths in 2012 or 9.2% of all cancer-related deaths (2). Fecal occult blood screening and improved treatment in recent decades have reduced the annual global mortality of colorectal cancer (3). The incidence of colorectal cancer varies widely by geographic region and by degree of development. Although

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Section: Discussionmentioning

confidence: 96%

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

et al. 2015

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“…They are agonists for the peroxisome proliferator-activated receptor (PPAR)-γ, one of a family of nuclear receptors concerned with metabolic fuel selection and storage [13]. We incorporated a control patient group randomised to receive insulin-providing therapy with glibenclamide, which does not to affect insulin resistance or postprandial lipid metabolism [14,15]. This was administered at a low dose in order to achieve glycaemic control similar to that of the pioglitazone group, as assessed by HbA 1 c. We also studied a group of nondiabetic subjects with the aim of assessing to what extent TZD treatment restored lipid and lipoprotein metabolism to normal.…”

Section: Introductionmentioning

confidence: 99%

The effect of sensitisation to insulin with pioglitazone on fasting and postprandial lipid metabolism, lipoprotein modification by lipases, and lipid transfer activities in type 2 diabetic patients

et al. 2006

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Aims/hypothesis: Insulin resistance is thought to be central to the pathogenesis of diabetic dyslipidaemia. We hypothesised that improving insulin sensitivity would improve fasting and postprandial triglyceride metabolism in patients with type 2 diabetes. To this aim we studied fasting and postprandial lipaemia in type 2 diabetic patients before and after sensitisation to insulin with pioglitazone, compared with that observed in patients on an insulinproviding regime. Methods: In a double-blind placebo-controlled protocol, 22 patients with type 2 diabetes were randomly allocated to receive either pioglitazone (45 mg/day) or glibenclamide (5 mg/day), for a 20-week period. Fasting and postprandial lipid metabolism were investigated at baseline and at the end of the treatment period. A group of non-diabetic subjects was also studied. Results: Compared with glibenclamide treatment, pioglitazone treatment decreased fasting triglyceride, glucose and insulin levels and the homeostasis model assessment score of insulin resistance. Decreased fasting triglyceride after pioglitazone treatment was due to reduced VLDL triglyceride, particularly VLDL-2. Lipoprotein lipase activity was unchanged by pioglitazone treatment but hepatic lipase showed a significant decrease. Pioglitazone treatment lowered total postprandial triglyceride, as well as chylomicron-and chylomicron-remnant retinyl palmitate levels to normal. Glucose disposal improved but remained abnormal. Conclusions/interpretation: Insulin sensitisation with pioglitazone has major effects in restoring postprandial lipaemia to normal, while also correcting fasting hypertriglyceridaemia; both factors may have consequences for atherogenic risk in diabetes.

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“…This may lie in its insulin-stimulated property. Studies indicated that insulin secretagogues reduced overall glycaemia and FBG superior to acarbose [3,13]. Other reports showed DPP-4 inhibitors were non-inferior to insulin secretagogues [14][15].…”

Section: Resultsmentioning

confidence: 99%

Saxagliptin is similar in glycaemic variability more effective in metabolic control than acarbose in aged type 2 diabetes inadequately controlled with metformin

Wang

Lin

Chen

et al. 2015

Diabetes Research and Clinical Practice

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Influence of treatment with acarbose or glibenclamide on insulin sensitivity in type 2 diabetic patients

Abstract: Our results show a more substantial improvement of glucose control under glibenclamide than under acarbose which, however, was not associated with an increase of insulin sensitivity.

Cited by 32 publications

References 30 publications

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

Use of an α-Glucosidase Inhibitor and the Risk of Colorectal Cancer in Patients With Diabetes: A Nationwide, Population-Based Cohort Study

The effect of sensitisation to insulin with pioglitazone on fasting and postprandial lipid metabolism, lipoprotein modification by lipases, and lipid transfer activities in type 2 diabetic patients

Saxagliptin is similar in glycaemic variability more effective in metabolic control than acarbose in aged type 2 diabetes inadequately controlled with metformin

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