Diabetes Care, Vol 19, Issue 3 252-254, Copyright © 1996 by American Diabetes Association

ARTICLES

A comparison of acarbose versus metformin as an adjuvant therapy in sulfonylurea-treated NIDDM patients

M Bayraktar, DH Van Thiel and N Adalar
Department of Endocrinology, Hacettepe University, Ankara, Turkey.

OBJECTIVE: To compare the effects of acarbose or metformin treatment used as an adjunct with a sulfonylurea agent in the treatment of NIDDM not adequately controlled with the use of a sulfonylurea agent alone. RESEARCH DESIGN AND METHODS: Of the poorly controlled female NIDDM patients on sulfonylurea treatment, 18 were randomly selected from the outpatient diabetic clinic for study. For 8 weeks, they received either acarbose (300 mg/daily) or metformin (1,500 mg/daily) in addition to sulfonylurea in a crossover design using a 3-week washout period between treatments. The efficacy of each drug regimen was assessed by measuring the levels of glycosylated hemoglobin, fasting and 2-h postprandial blood glucose (PPBG) levels, cholesterol, triglyceride, and fibrinogen levels before and after 8 weeks of therapy. RESULTS: The metabolic parameters measured before initiation of either treatment regimen were similar. Mean fasting and 2-h postprandial glucose levels were reduced moderately at the end of 8 weeks of both combination treatments (P < 0.05). Although the fasting and 2-h postprandial plasma insulin and C-peptide and fibrinogen levels at the end of the 8-week treatment periods were lower than those obtained at the beginning of the study, the differences between these values were not statistically significant. Cholesterol levels remained unchanged. Only the 2-h PPBG level in the group using acarbose plus a sulfonylurea was lower than the level achieved by the group using metformin plus a sulfonylurea (8.1 +/- 0.8 vs. 9.8 +/- 1.0 mmol/l, respectively, P < 0.05). The difference between pre- and posttreatment levels of the 2-h PPBG level in both arms of the study were statistically significant (delta-acarbose, 5.3 +/- 0.4 vs. delta-metformin, 2.9 +/- 0.3) (P < 0.05). Specific drug-associated side effects were observed in 12 patients on acarbose and 3 patients on metformin. CONCLUSIONS: Acarbose or metformin can be used as effective adjuvant therapies with a sulfonylurea agent in NIDDM patients who are poorly controlled with the sulfonylurea agent alone.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				T. L. Skaer, D. A. Sclar, and L. M. Robison Trends in the Prescribing of Oral Agents for the Management of Type 2 Diabetes Mellitus in the United States, 1990-2001: Does Type of Insurance Influence Access to Innovation? The Diabetes Educator, November 1, 2006; 32(6): 940 - 953. [Abstract] [Full Text] [PDF]

				A. Y.Y. Cheng and I. G. Fantus Oral antihyperglycemic therapy for type 2 diabetes mellitus Can. Med. Assoc. J., January 18, 2005; 172(2): 213 - 226. [Abstract] [Full Text] [PDF]

				S. R. Salpeter, E. Greyber, G. A. Pasternak, and E. E. Salpeter Risk of Fatal and Nonfatal Lactic Acidosis With Metformin Use in Type 2 Diabetes Mellitus: Systematic Review and Meta-analysis Arch Intern Med, November 24, 2003; 163(21): 2594 - 2602. [Abstract] [Full Text] [PDF]

				P. Phillips, J. Karrasch, R. Scott, D. Wilson, and R. Moses Acarbose Improves Glycemic Control in Overweight Type 2 Diabetic Patients Insufficiently Treated With Metformin Diabetes Care, February 1, 2003; 26(2): 269 - 273. [Abstract] [Full Text] [PDF]

				R. A. DeFronzo Pharmacologic Therapy for Type 2 Diabetes Mellitus Ann Intern Med, August 17, 1999; 131(4): 281 - 303. [Abstract] [Full Text] [PDF]