5643
document
Effect of acarbose on additional insulin therapy in type 2 diabetic patients with late failure of sulphonylurea therapy . AIM The present study investigated the effect of acarbose on insulin requirements and glycaemic control in patients with type 2 diabetes receiving exogenous insulin due to secondary failure of maximum dose sulphonylurea therapy . METHODS A single-centre , double-blind , randomized , placebo-controlled study was performed in 48 type 2 diabetic patients with late-term failure following at least 3 years of sulphonylurea therapy requiring additional insulin therapy to determine the impact of acarbose on glycaemic control and insulin requirements . The primary end points were glycaemic response rate ( responders being predefined as patients who achieve a decrease in HbA1c to less than 8 % or a reduction by at least 15 % as compared to the baseline values ) and the daily insulin dose at 6 months . Secondary parameters assessed included postprandial changes in blood glucose , serum insulin and C-peptide during the treatment period . RESULTS There were significantly more responders in the acarbose-treated group compared with the placebo group ( 20/24 patients vs. 10/19 patients ; p < 0.05 ) . The mean daily insulin dose after 24 weeks of treatment was 16.4 +/- 10.1 IU in the acarbose group and 22.4 +/- 12.2 IU in the placebo group ( mean +/- s.d . ; p < 0.07 ) . Postprandial increases in blood glucose , insulin and C-peptide were consistently lower in the acarbose-treated group than in the placebo group . For example , the mean increase in 2-h postprandial serum insulin remained almost unchanged in the acarbose group at the end of 24 weeks of treatment compared to an increase to 43 +/- 29 microU/ml ( mean +/- s.d . ) at the end of the study period for the placebo group . CONCLUSIONS The findings of this study suggest that the addition of acarbose to sulphonylurea/insulin combination therapy can improve glycaemic control in type 2 diabetic patients . Acarbose may also reduce insulin resistance and hyperinsulinaemia .
5644
Intervention_Pharmacological
acarbose
5645
Intervention_Pharmacological
insulin therapy
5646
Intervention_Pharmacological
acarbose
5647
Intervention_Pharmacological
insulin
5648
Intervention_Control
placebo-controlled
5649
Intervention_Pharmacological
sulphonylurea
5650
Intervention_Pharmacological
insulin
5651
Intervention_Pharmacological
acarbose
5652
Intervention_Pharmacological
insulin
5653
Intervention_Pharmacological
insulin
5654
Intervention_Pharmacological
insulin
5655
Intervention_Pharmacological
acarbose
5656
Intervention_Control
placebo
5657
Intervention_Control
placebo
5658
Intervention_Pharmacological
insulin
5659
Intervention_Control
placebo
5660
Intervention_Pharmacological
acarbose
5661
Intervention_Pharmacological
sulphonylurea/insulin
5662
Intervention_Pharmacological
Acarbose
5663
Outcome_Physical
insulin requirements
5664
Outcome_Physical
glycaemic control
5665
Outcome_Physical
glycaemic response rate
5666
Outcome_Physical
daily insulin dose
5667
Outcome_Physical
postprandial changes in blood glucose , serum insulin and C-peptide
5668
Outcome_Physical
mean daily insulin dose
5669
Outcome_Physical
Postprandial increases in blood glucose
5670
Outcome_Physical
insulin
5671
Outcome_Physical
C-peptide
5672
Outcome_Physical
mean increase in 2-h postprandial serum insulin
5673
Outcome_Physical
glycaemic control
5674
Outcome_Physical
insulin resistance and hyperinsulinaemia .
5675
Participant_Condition
type 2 diabetic
5676
Participant_Condition
late failure
5677
Participant_Condition
sulphonylurea therapy
5678
Participant_Condition
type 2 diabetes
5679
Participant_Condition
exogenous insulin
5680
Participant_Condition
failure
5681
Participant_Condition
sulphonylurea therapy
5682
Participant_Sample-size
48
5683
Participant_Condition
type 2 diabetic
5684
Participant_Condition
late-term failure
5685
Participant_Condition
sulphonylurea therapy
5686
Participant_Condition
insulin therapy
5687
Participant_Condition
type 2 diabetic