Evaluation of the Efficacy and Tolerability of Acarbose in Patients with Diabetes Mellitus
Objective: The efficacy and tolerability of acarbose were examined in a postmarketing surveillance study of 27 803 patients with diabetes mellitus (26 044 were diagnosed as having type 2 diabetes) over a 12-week treatment period.
Patients and methods: Overall efficacy data were reported for type 1 and type 2 diabetes, and a detailed data analysis was conducted for patients with type 2 diabetes. Tolerability was described for the total group. Of the type 2 diabetes patients, 37.6% were treated with diet only; 44.2% were additionally treated with sulphonylureas; 6.3% with metformin or metformin plus sulphonylurea; and 11.6% with insulin alone or in combination with oral treatment. The frequency of two or more concomitant diseases was 45.8% for all type 2 diabetes patients, and 62.4% in elderly patients (age ≥70 years).
Results: In patients with type 2 diabetes, acarbose administration in addition to the existing treatment resulted in reductions in mean blood glucose levels (fasting 50 mg/dL, lh post-prandial [pp] 60 mg/dL, 2h pp 56 mg/dL), glycosylated haemoglobin (HbA1c 1.3%; HbA1 1.6%) and bodyweight (1.5 kg). Results for type 1 diabetes patients were similar. No clinically relevant influence of age, body mass index or number of concomitant diseases on the results could be observed. Tolerability was good: 83% of patients had no adverse events, 13.7% reported flatulence, and 2.2% had at least one occurrence of diarrhoea. Hypoglycaemia was found in 0.07% of patients, mainly in combination with metformin or insulin. Tolerability was independent of patients’ age. Laboratory investigations gave no indication of other adverse events.
Conclusion: This postmarketing surveillance study documents the therapeutic benefit and good tolerability and compliance of acarbose as mono- and combination therapy, even in elderly and multimorbid patients.
KeywordsMetformin Acarbose Concomitant Disease Sulphonylurea Oral Antidiabetic Drug
The authors thank Bayer Vital GmbH, Leverkusen, Germany, for funding the study and Datan, Havixbeck, Germany for data processing.
- 1.Lebovitz HE. α-Glucosidase inhibitors as agents in the treatment of diabetes. Diabetes Rev 1998; 6: 132–45Google Scholar
- 2.Spengler M, Cagatay M. Bewertung der Wirksamkeit und Verträglichkeit von Acarbose durch Anwendungsbeobachtung. Diab Stoffw 1992; 1: 218–22Google Scholar
- 3.Braun H, Belser F. Inhibiteur de l’alpha-glucosidase chez le diabétique. Efficacité et tolérance de l’acarbose en practique courante. DIA/GM (Swiss) 1994; 9: 654–6Google Scholar
- 5.Bergamini L, Cocilov L, Giorgino R, et al. Acarbose in non-insulin-dependent diabetic patients in routine clinical practice: results from a multicentre study. Ann Exp Clin Med 1997; 1–2: 45–51Google Scholar
- 10.Standl E, Stiegler H, Janka HU, et al. Risk profiles of macrovascular diseases in diabetes mellitus. Diab Med 1988; 14: 505–11Google Scholar
- 11.Nationale Versorgungsleitlinie Diabetes mellitus Typ 2, 1. Auflage Mai 2002, ÄZQ-Redaktion Versorgungsleitlinien, Aachener Str. 233–237, D-50931 KölnGoogle Scholar
- 15.Hollander PA. Acarbose: adverse events and safety profile. Drug Benefit Trends 1996; (Suppl E) 8: 46–54Google Scholar