The effects of acarbose therapy on reductions of myocardial infarction and all-cause death in T2DM during 10-year multifactorial interventions (The Beijing Community Diabetes Study 24)

Abstract

To investigate the potential benefits of acarbose therapy on cardiovascular events (CVD) in Type 2 diabetes (T2DM) in an urban community over 10-year follow-up. The study population of Beijing Community Diabetes Study (BCDS) were type 2 diabetes (T2DM) living in 21 communities in Beijing. All patients received comprehensive intervention in accordance with the Chinese guidelines for the prevention and treatment of diabetes. Professors in endocrinology from top tier hospitals regularly visited the communities for consultations, which was a feature of this study. A total of 1797 T2DM in BCDS study had complete screening data, including blood glucose, blood pressure, lipid profiles and acarbose continuous therapy. After 10-year follow-up, the risks of CVD outcomes were assessed according to whether patients had received acarbose therapy or not. All patients were followed-up to assess the long-term effects of the multifactorial interventions. At baseline, compared with the acarbose therapy free in T2DM, there was no significant difference in achieving the joint target control in patients with acarbose therapy. From the beginning of 8th year follow-up, the joint target control rate in patients with acarbose therapy was significantly higher than that of acarbose therapy free. During the 10-year follow-up, a total of 446 endpoint events occurred, including all-cause death, cardiovascular events, cerebrovascular events. The incidences of myocardial infarction (from the 4th year of follow-up) and all-cause death (from the 2nd year of follow-up) in patients who received acarbose therapy were significantly lower than that of acarbose therapy free respectively. In Cox multivariate analyses, there were significant differences in incidences of myocardial infarction and all-cause death between afore two groups during the 10-year follow-up, and the adjusted HRs were 0.50 and 0.52, respectively. After multifactorial interventions, T2DM with acarbose therapy revealed significant reductions of myocardial infarction and all-cause death. The long-term effects of with acarbose therapy on improving joint target control might be one of the main reasons of myocardial infarction and all-cause death reduction.Trial Registration: ChiCTR-TRC-13003978, ChiCTR-OOC-15006090.

Molecular inhibition of RAS signalling to target ageing and age-related health

“…Acarbose also increases the median lifespan of male mice by 16-17% and that of female mice by 4-5% ( Harrison et al, 2019 ). In humans, acarbose therapy significantly reduced the incidence of myocardial infarctions and all-cause deaths in patients with type 2 diabetes, suggesting that acarbose can improve health and thus potentially extend lifespan ( Zhang et al, 2021 ). Currently, acarbose is in Phase 2 clinical trials to study its effects during ageing in individuals aged 60-100 years ( Garay, 2021 ).…”

Acarbose is again on the stage

“…It has also been found that acarbose reduces cardiovascular events in patients with IGT and T2DM. In a recently published study, Zhang et al [ 11 ] found a 50% relative risk (RR) reduction in myocardial infarction and a 52% RR reduction in all-cause deaths after a 10-year follow-up with regard to acarbose therapy in patients with T2DM[ 11 ]. This effect is due to the reduction of oxidative stress caused by the lowering of postprandial two-hour blood sugar.…”