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Objective:To describe the current status and efficacy of additional acarbose combined with insulin therapy in adult patients with type 1 diabetes mellitus (T1DM) .Methods:Adult T1DM patients with acarbose combined with insulin (acarbose group) or insulin alone (insulin group), age≥18 years and disease course≥1 year, who were registered in the T1DM Translational Medicine Research Project of Guangdong Province from June 2011 to December 2014 were enrolled in the study. The hemoglobin A1c (HbA 1c), body weight, body mass index (BMI), waist-to-hip ratio (WHR), insulin dosage and hypoglycemia of acarbose group and insulin group after 1 year were compared. Results:A total of 717 adult patients with T1DM were included (62 cases in acarbose group and 655 cases in insulin group). At the time of enrollment, the onset age of acarbose group was higher than that of insulin group [(31.1±12.3)years vs (27.4±12.4)years, P=0.019]; There were no significant differences in gender, age, course of disease, body weight, BMI, WHR, proportion of carbohydrate heat ≥50%, proportion of exercise time ≥150 min per week, HbA 1c, dosage of insulin, occurence of hypoglycemia and proportion of patients with dyslipidemia between the 2 groups (all P>0.05). After 1 year of follow-up, the HbA 1c in acarbose and insulin group decreased from baseline ( P=0.014, P<0.001), the body weight and BMI increased from baseline (all P<0.05), but WHR, insulin dosage and hypoglycemia occurrence were not statistically significant between the two groups (all P>0.05). After 1 year of follow-up, there were no significant difference in changes of HbA 1c, body weight, BMI, WHR, insulin dosage and hypoglycemia occurrence in acarbose group compared with insulin group from baseline (all P>0.05). Conclusions:In the clinical practice of T1DM treatment, acarbose is used more frequently in patients with a slightly older age of onset. Treatment of T1DM with insulin combined with acarbose did not increase the incidence of hypoglycemia, and no benefit was observed in improving HbA 1c, maintaining body weight, and reducing insulin use.
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Acarbose is widely used as α-glucosidase inhibitor in the treatment of type Ⅱ diabetes. Actinoplanes sp. is used for industrial production of acarbose. As a secondary metabolite, the biosynthesis of acarbose is quite complex. In addition to acarbose, a few acarbose structural analogs are also accumulated in the culture broth of Actinoplanes sp., which are hard to remove. Due to lack of systemic understanding of the biosynthesis and regulation mechanisms of acarbose and its structural analogs, it is difficult to eliminate or reduce the biosynthesis of the structural analogs. Recently, the advances in omics technologies and molecular biology have facilitated the investigations of biosynthesis and regulatory mechanisms of acarbose and its structural analogs in Actinoplanes sp.. The genes involved in the biosynthesis of acarbose and its structural analogs and their regulatory mechanism have been extensively explored by using bioinformatics analysis, genetic manipulation and enzymatic characterization, which is summarized in this review.
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Humans , Acarbose/metabolism , Diabetes Mellitus, Type 2/drug therapy , Genetic TechniquesABSTRACT
Objective:To explore the effect of Shenqi Maiwei Dihuangtang （SQMWDH） combined with acarbose on the level of 2-hour oral glucose tolerance test （2 h OGTT），body mass index （BMI）， and abdominal fat thickness in patients with impaired glucose tolerance （IGT）. Method:A total of 130 patients with IGT admitted to the First People's Hospital of Shuangliu District from February 2017 to January 2019 were divided into a control group and a treatment group by a random number table. All patients received conventional treatment， such as diet regulation and exercise. The patients in the control group received additional oral administration of acarbose，while those in the treatment group were treated with SQMWDH based on the control group. Fasting blood glucose （FBG），2 h OGTT， and glycated hemoglobin A1c（HbA1c）levels were measured by the blood glucose meter. Abdominal fat thickness was measured by ultrasound tomography，and serum total cholesterol （TC），triglyceride （TG），adiponectin， and leptin levels in fasting venous blood were measured. Result:After treatment，the total response rate of the treatment group was higher than that of the control group （95.00% vs. 81.67%， <italic>χ</italic><sup>2</sup>=5.175，<italic>P</italic><0.05）. Before treatment，there was no significant difference in FBG，2 h OGTT，HbA1c， BMI，waist circumference，abdominal fat thickness，TC，TG，adiponectin， and leptin of IGT patients between the two groups. After treatment，the levels of FBG，2 h OGTT，HbA1c， BMI，waist circumference，abdominal fat thickness，TC，TG，and leptin of IGT patients were lower than those before treatment in both groups （<italic>P</italic><0.05）， and the treatment group was inferior to the control group（<italic>P</italic><0.05，<italic>P</italic><0.01）. The level of adiponectin after treatment was higher than that before treatment in both groups （<italic>P</italic><0.05），and the treatment group was superior to the control group （<italic>P</italic><0.05）. Conclusion:SQMWDH combined with acarbose is effective in treating IGT patients by effectively reducing 2 h OGTT and abdominal fat thickness to alleviate obesity and improve the constitution of patients.
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OBJECTIVE：To summarize and analyze t he clinical characteristics of acarbose-induced skin ADR ，and to provide reference for its therapy. METHODS ：Clinical pharmacists participated in the treatment of a patient with acarbose-induced skin ADR. The patient developed erythema multiforme several days after oral administration of Acarbose tablets （100 mg/d）. After consultation by dermatology and clinical pharmacy ，considering that the adverse reaction was related to acarbose ，clinical pharmacists suggested to stop the drug. Based on the above cases ，clinical pharmacists searched Wanfang database ，CNKI， PubMed，Embase and other databases to collect case reports of skin ADR caused by acarbose ，summarize its general situation （gender，age，usage and dosage ，etc.），latency，ADR（diagnosis and manifestation ），intervention and outcome ，etc. RESULTS ： The doctor adopted the pharmacist s’advice，stopped the use of acarbose ，and gave symptomatic treatment as Methylprednisolone sodium succinate for injection 40 mg（intravenous injection ，qd）+Medloratadine tablets 8.8 mg（oral administration ，qd）+Calamine lotion（for external use ）. The patient improved and was discharged after 10 days. A total of 12 literatures involving 12 patients were retrieved. Among the 13 patients included in the analysis （including the above clinical case and 12 literature cases ），there were 8 males and 5 females，and 8 patients of them aged 50 and over；the dosage of acarb ose in most patients was within the requirements of the drug instructions. The primary diseases of 12 patients were diabetes mellitus. The latency of skin ADR in 11 patients was within 6 days of administration. Among the 13 patients，the ADR were diagnosed as rash in 4 cases，pustulosis in 3 cases， erythema multiforme in 2 cases， urticaria in 2 cases， maculopapular rash in 1 case and lip swelling in 1 case. The ADR of 1 patient improved after drug withdrawal ，and 12 patients also improved after drug withdrawal and symptomatic treatment such as glucocorticoid or antihistamine. Acarbose was re-used in 2 patients after the improvement of first skin ADR ，and skin ADR occurred again ，and the ADR were improved after drug withdrawal and symptomatic treatment. CONCLUSIONS ：Skin ADR are acarbose-induced rare ADR ，mostly within 6 days of medication ，and are more likely to occur in middle-aged and older men. When the patients suffer from ADR ，the drug should be stopped in time and given glucocorticoids or antihistamines for symptomatic treatment. Clinical pharmacists should do a good job in drug publicity and education ，remind patients to closely monitor relevant indicators and ensure drug safety.
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Objective:To observe the changes of skeletal muscle indexes in elderly patients with type 2 diabetes complicated with sarcopenia treated with sitagliptin and acarbose.Methods:A total of 60 patients over 60 years old with type 2 diabetes complicated with sarcopenia in Dalian Municipal Central Hospital from January 2019 to January 2020 were selected and divided into two groups by random number table method.One group received sitagliptin and metformin,and the other group received acarbose and metformin. The changes of skeletal muscle indexes, glucagon-like peptides-1 (GLP-1), insulin resistance index (HOMA-IR) and inflammatory indexes were compared between the two groups at baseline and 36 weeks after treatment.Results:After treatment, the skeletal muscle index (SMI) of sitagliptin group was increased (5.94 ± 1.52 vs. 5.99 ± 1.52), and the difference was statistically significant ( P<0.05). Muscle strength and SMI decreased in acarbosse group (18.75 ± 4.64 vs. 17.72 ± 4.44, 6.09 ± 1.74 vs. 6.00 ± 1.71), with statistical significance ( P<0.05). GLP-1 increased in sitagliptin group, 0 min: (10.65 ± 1.68) pmol/L vs. (12.41 ± 1.88) pmol/L; 60 min: (22.79 ± 2.85) pmol/L vs. (25.51 ± 2.79) pmol/L; 120 min: (24.26 ± 2.94) pmol/L vs. (29.49 ± 2.91) pmol/L; 180 min: (11.68 ± 1.84) pmol/L vs. (12.88 ± 1.83) pmol/L. There were significant differences ( P<0.05). HOMA-IR and CRP decreased: 4.73 ± 3.04 vs. 3.16 ± 2.41, (2.39 ± 0.50) mg/L vs. (2.33 ± 0.43) mg/L, and the differences were statistically significant ( P<0.05). HOMA-IR in acarbose group decreased after treatment (5.80 ± 3.94 vs. 4.00 ± 1.63), and the difference was statistically significant ( P<0.05). Comparison between the two groups after treatment, the decreased value of muscle strength in sitagliptin group was less than that in acarbose group, and the difference was statistically significant ( P<0.05). GLP-1 and overall GLP-1 area under the curve in sitagliptin group were higher than those in acarbose group (67.64 ± 6.81 vs. 58.98 ± 6.72), with statistical significance ( P<0.05). HOMA-IR and CRP in sitagliptin group were lower than those in acarborose group: 3.16 ± 2.42 vs. 4.00 ± 1.63, (2.33 ± 0.43) mg/L vs. (2.41 ± 0.70) mg/L, with statistical significances ( P<0.05). Conclusions:Sitagliptin therapy improves muscle mass and protects muscle strength in elderly patients with type 2 diabetes mellitus and sarcopenia.
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BACKGROUND: We evaluated the efficacy and safety of acarbose add-on therapy in Korean patients with type 2 diabetes mellitus (T2DM) who are inadequately controlled with metformin and sitagliptin. METHODS: A total of 165 subjects were randomized to metformin and sitagliptin (Met+Sita, n=65), metformin, sitagliptin, and acarbose (Met+Sita+Acarb, n=66) and sitagliptin and acarbose (Sita+Acarb, exploratory assessment, n=34) therapy in five institutions in Korea. After 16 weeks of acarbose add-on or metformin-switch therapy, a triple combination therapy was maintained from week 16 to 24. RESULTS: The add-on of acarbose (Met+Sita+Acarb group) demonstrated a 0.44%±0.08% (P<0.001 vs. baseline) decrease in glycosylated hemoglobin (HbA1c) at week 16, while changes in HbA1c were insignificant in the Met+Sita group (−0.09%±0.10%, P=0.113). After 8 weeks of triple combination therapy, HbA1c levels were comparable between Met+Sita and Met+Sita+Acarb group (7.66%±0.13% vs. 7.47%±0.12%, P=0.321). Acarbose add-on therapy demonstrated suppressed glucagon secretion (area under the curve of glucagon, 4,726.17±415.80 ng·min/L vs. 3,314.38±191.63 ng·min/L, P=0.004) in the absence of excess insulin secretion during the meal tolerance tests at week 16 versus baseline. The incidence of adverse or serious adverse events was similar between two groups. CONCLUSION: In conclusion, a 16-week acarbose add-on therapy to metformin and sitagliptin, effectively lowered HbA1c without significant adverse events. Acarbose might be a good choice as a third-line therapy in addition to metformin and sitagliptin in Korean subjects with T2DM who have predominant postprandial hyperglycemia and a high carbohydrate intake.
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Humans , Acarbose , Diabetes Mellitus, Type 2 , Drug Therapy, Combination , Glucagon , Glycated Hemoglobin , Hyperglycemia , Incidence , Insulin , Korea , Meals , Metformin , Sitagliptin PhosphateABSTRACT
Objective@#To analyze the clinical efficacy of Acarbose on type 2 diabetes mellitus combined with postprandial hypotension (PPH) in elderly patient.@*Methods@#A total of 60 elderly patients with type 2 diabetes mellitus and PPH who were diagnosed and treated at our hospital from July 2016 to December 2017 were enrolled in this study.Patients were given Acarbose intervention for two weeks.The changes of blood pressure, heart rate and blood glucose before and after treatment were monitored, and the therapeutic effects and side effects were evaluated.@*Results@#After Acarbose intervention, postprandial systolic pressure (F=9.311, P=0.033), diastolic pressure (F=8.710, P=0.026) and mean arterial pressure (F=7.710, P=0.021) were decreased significantly in elderly patients with type 2 diabetes mellitus and PPH by comparison with those before intervention.There was no significant difference in heart rate fluctuation(F=8.091, P=0.069)and in fasting blood glucose level(t=0.209, P=0.120)before and after treatment.The 2-hour postprandial blood glucose level was lower in elderly patients with diabetes mellitus and PPH after treatment of acarbose than before treatment [(7.9±0.9)mmol/L vs. (8.9±1.9)mmol/L, t=18.310, P=0.003]. The incidence rate of PPH was 100.0% before treatment, and decreased to 43.3% (26/60) after acarbose intervention (χ2=51.430, P=0.000). There were 5 patients with adverse reactions, and the incidence rate of adverse reactions was 8.3%(5/60), and no patients had cerebral ischemia.@*Conclusions@#Acarbose can alleviate postprandial blood pressure, decrease the fluctuation of postprandial blood glucose and reduce the incidence of PPH, which has a high safety.It may be one of the effective measures in treating diabetes mellitus combined with postprandial hypotension in the elderly.
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Objective To analyze the clinical efficacy of Acarbose on type 2 diabetes mellitus combined with postprandial hypotension (PPH) in elderly patient.Methods A total of 60 elderly patients with type 2 diabetes mellitus and PPH who were diagnosed and treated at our hospital from July 2016 to December 2017 were enrolled in this study.Patients were given Acarbose intervention for two weeks.The changes of blood pressure,heart rate and blood glucose before and after treatment were monitored,and the therapeutic effects and side effects were evaluated.Results After Acarbose intervention,postprandial systolic pressure (F =9.311,P =0.033),diastolic pressure (F =8.710,P =0.026) and mean arterial pressure (F =7.710,P =0.021) were decreased significantly in elderly patients with type 2 diabetes mellitus and PPH by comparison with those before intervention.There was no significant difference in heart rate fluctuation(F =8.091,P =0.069) and in fasting blood glucose level(t =0.209,P =0.120) before and after treatment.The 2-hour postprandial blood glucose level was lower in elderly patients with diabetes mellitus and PPH after treatment of acarbose than before treatment [(7.9±0.9)mmol/L vs.(8.9±1.9)mmol/L,t =18.310,P=0.003].The incidence rate of PPH was 100.0％ before treatment,and decreased to 43.3％ (26/60) after acarbose intervention (x2 =51.430,P =0.000).There were 5 patients with adverse reactions,and the incidence rate of adverse reactions was 8.3 ％ (5/60),and no patients had cerebral ischemia.Conclusions Acarbose can alleviate postprandial blood pressure,decrease the fluctuation of postprandial blood glucose and reduce the incidence of PPH,which has a high safety.It may be one of the effective measures in treating diabetes mellitus combined with postprandial hypotension in the elderly.
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OBJECTIVE: To evaluate the bioequivalence of acarbose tablet in healthy Chinese volunteers through the use of pharmacodynamics endpoint parameters of serum glucose. METHODS: Following the Food and Drug Administration (FDA) guidance, a single oral dose of test and reference formulations was given to 32 healthy Chinese volunteers according to a randomized crossover design. Serum glucose concentrations after sucrose administration and co-administration of sucrose and acarbose on the following day were both determined. The reduction of serum glucose concentration were calculated following treatment with acarbose and sucrose together relative to the baseline serum glucose concentration observed. The parameters of Δcmax and AUEC0-4 h recommended by the FDA were used for bioequivalence evaluation. Four pharmacodynamics parameters of AUEC0-2 h,AUEC0-1.5 h, AUEC0-1.0 hand ΔGE were also tested in the evaluation. RESULTS: The main pharmacodynamics parameters of serum glucose in test and reference formulations were as follows:Δcmax (1.169±0.719) and (0.878±0.571) mmol·L-1, AUEC0-2 h(46±25) and (50±21) mmol·min·L-1, AUEC0-1.5 h(62±42) and (70±29) mmol·min·L-1, AUEC0-1 h(59±52) and (73±32) mmol·min·L-1, ΔGE(1.829±0.952) and (1.656±0.764) mmol·L-1, respectively. The parameter AUEC0-4 h could not be evaluated due to the presence of negative values. CONCLUSION: Acarbose tablet is bioinequivalent to the reference tablet.This might be related to acarbose dose, the 50 mg dose of acarbose tablet is inadequate. Pharmacodynamics parameters which is suitable to demonstrate acarbose bioequivalence might also need to be optimized.
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Objective:To observe the intervention effect of acarbose on cerebral arterial thrombosis complicated with impaired glu-cose tolerance(IGT).Methods: Totally 120 cases of IGT patients with ischemic stroke were randomly divided into the observation group (58 cases) and the control group(62 cases). The two groups were given the same basic treatment,while the observation group was treated with acarbose 50 mg,po,tid for 3 months additionally. Before and after the treatment,the levels of blood lipid and blood glucose,serum high-sensitivity C reactive protein(hsCRP) and carotid intima media thickness(IMT) and the other adverse drug reac-tions were detected in the two groups. After 6-month follow-up,the new incidence of IGT was compared between the groups.Results:After the treatment,2 hPG,HbAlc,hsCRP and the other indicators in the observation group were significantly improved when com-pared with those before the treatment(P<0.01 or P<0.05),while only hsCRP in the control group was significantly improved when compared with that before the treatment(P<0.05) and that in the observation group. 2 hPG,HbAlc,hsCRP,IMT and the other in-dicators in the observation group were significantly better than those in the control group(P<0.01 or P<0.05). There was no signifi-cant change in the level of blood lipid in the two groups. There was no adverse drug reaction during the treatment. After the 6-month follow-up,the new incidence of IGT in the observation group was 1.82%,which was significantly lower than that in the control group (7.27%,P<0.05).Conclusion: Among the patients with cerebral arterial thrombosis complicated with impaired glucose tolerance, the normal treatment measures plus acarbose can effectively delay carotid artery IMT incrassation and decrease the risk of cardiovascular events recurrence with better relative safety.
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Objective To evaluate efficacy and safety of acarbose compared with metformin as add-on therapy in patients with type 2 diabetes mellitus inadequately controlled with insulin. Methods This was a randomized, open-labeled, and parallel group study. Ninety-one type 2 diabetic patients ( HbA1C7.5%-11.0%) who were suboptimally controlled despite receiving twice daily injection of insulin (30-60 U/d for at least 8 weeks) were enrolled. They were randomly assigned 1 ∶ 1 ∶ 1 to continuation of insulin, insulin with acarbose (Ins+Aca), and insulin with metformin (Ins+Met) groups to insulin treatment. The levels of HbA1C, oral glucose tolerance test, blood lipids etc were measured at baseline and 12 weeks, and adverse events were recorded. Results The mean HbA1C levelsdecreasedfrom(7.9±0.4)%atbaselineto(7.0±0.3)%atweek12(P＜0.01)intheIns+Acagroupand(7.8 ±0.2)%to(7.0±0.3)%in the Ins+Met group(P＜0.01), while no significant change in HbA1Cin the insulin alone group. Adding acarbose to insulin resulted in similar reductions in HbA1Crelative to metformin (P＝0.431). The achievement rate of HbA1Cbelow 7.0%at week 12 was the same(both 70%) between the Ins+Aca group and the Ins+Met group. Insulin combined with acarbose in improving blood glucose fluctuation effect was more significant than that incombinationwithmetformin(P＜0.01),withstandarddeviation(SD)ofbloodglucose[(1.1±0.5vs2.7±0.6) mmol/L, P＜0.01], postprandial blood glucose fluctuations [(0.5 ± 0.7 vs 2.8 ± 0.4) mmol/L, P＜0.01], the maximumbloodglucosefluctuations[(2.8±0.7vs4.6±0.6)mmol/L,P＜0.01].Theweightlossoccurredinboththe Ins+AcaandtheIns+Metgroups[-(0.5±0.8vs1.0±0.4)kg].Therewasnosignificantchangesinbloodpressure and lipid profile. Hypoglycemic episodes were comparable in all groups. No serious adverse event was noted in any group. Conclusions Adding acarbose or metformin to insulin therapy could achieve improvements in glycemic control with similar reductions in HbA1Clevels and weight, when comparing with insulin treatment alone. Add-on acarbose to insulin therapy may exist more effectively on glucose fluctuation than that of add-on metformin, which may have important clinical implications in those patients with postprandial hyperglycemia, large blood glucose fluctuation, and intolerance to metformin.
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Pre-diabetes is at increased risk of development of type 2 diabetes and future cardiovascular events. Preventing the progression of pre-diabetic populations to diabetes is important. The Acarbose Cardiovascular Evaluation(ACE) trial was the largest pre-diabetes intervention study conducted in China. The study found that acarbose treatment can significantly reduce the risk of new-onset diabetes in IGT patients with CVD on the basis of life interventions,but the cardiovascular benefits for the population are not significant. ACE study showed that acarbose can prevent the conversion of IGT to diabetes,which plays a key role in the prevention of diabetes.
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ACE is an important clinical trial. It attracted much attention in the field of diabetes and cardiology worldwide. Acarbose did not increase the number of cardiovascular events in ACE, which demonstrated it′s safety in pre-diabetes people who experienced a cardiovascular disease previously. But this agent also did not reduce the composite CVD endpoints, shedding a challenge to the notion that postprandial glucose rise is a specific risk factor to predict cardiovascular events. ACE trial successfully confirmed the effect of acarbose on the prevention of diabetes in subjects with impaired glucose tolerance, bnt to a less extent compared with the STOP-NIDDM trial. The higher number of subjects needed to be treated for the prevention of diabetes in ACE trial than that seen in other intervention trials should be taken into account in the decision making for using acarbose to prevent diabetes in a large scale population as far as the cost-effectiveness is concerned.
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Objective To investigate the clinical effect and analysis of Shah Glenn Dean combined with acarbose in the treatment of newly diagnosed elderly patients with type 2 diabetes mellitus.Methods 60 cases of newly diagnosed elderly patients treated in our hospital during the period from January 2015 to January 2017 in patients with type 2 diabetes mellitus is selected as the object of this study, they were randomly divided into control group and study group, 30 cases in each group.The control group was treated with acarbose treatment, the study group was treated with Shah Glenn Dean combined acarbose treatment, treatment time was 3months, glycosylated hemoglobin, after two groups of patients were in different treatment of hypoglycemia were observed and compared the rate of change, body mass index and blood glucose level changes.Results The patients in the control group, the incidence of hypoglycemia was 23.33%, patients in the study group, the incidence of hypoglycemia was 6.67%, patients in the study group,the incidence of hypoglycemia was significantly lower than that of control group, the difference was statistically significant between the groups(P <0.05); glycosylated hemoglobin levels in the study group were significantly lower than that of the control group of two patients, the difference was statistically significant between the groups(P <0.05); the total cost of the patients in the treatment group compared with the control group had no significant difference, the difference was not statistically significant.Conclusion Significant clinical therapeutic effect of saxagliptin combined with acarbose in the treatment of newly diagnosed elderly patients with type 2 diabetes, can make the patient's blood glucose levels were significantly lower,with high security, the incidence of hypoglycemia was significantly reduced, but also can reduce the weight of patients, the total cost in the course of treatment did not increase that will not cause economic burden on patients, it is worthy of clinical application.
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Objective To probe into the effect of sitagliptin on blood glucose fluctuation of the patients with type 2 diabetes mellitus(T2DM) and poor control by insulin aspart 30.Methods Ninety cases of T2DM and poor control by insulin aspart 30 in affiliated Zhongshan hospital from January 1,2014 to December 31,2014 were selected and randomly divided into three groups:simply continuous subcutaneous insulin injection(CSII),acarbose combined CSII group(CSII + Aca) and sitagliptincombined CSII group (CSII + Sig),30 cases in each group.Three groups received the intensive treatment for 2 weeks,and72-h continuous glucose monitoring was performed on last 3 d.The 24 h mean blood glucose(24 hMBG),largest amplitude of glycemic fluctuation(LAGE),mean amplitude of glycemic excursion(MAGE) within 1 d,postprandial blood glucose spike(PGS),postprandial glucose peak time(△t),postprandial glucose excursion(PPGE) and total T were observed within 24 h.The difference of insulin dose(△ insulin),hypoglycemia incidence,glucose-target rate,blood glucose profiles were compared at the end of treatment.Results After two-week treatment,intraday blood glucose variation indicators(24 hMBG,LAGE and MAGE) and postprandial blood glucose variation indicators (PGS,△t,PPGE and total T) in the CSII+Sig and CSII+-Aca groups were significantly lower than those in the CSII group(P＜ 0.05),while the differences in blood glucose variation indicators between the CSII+Sig group and CSII+-Aca group were not statistical significant(P＞ 0.05).In the comparison after treatment,△ insulin,hypoglycemia incidence and glucose-target rate in the CSI + Sig group were lower(P＜0.05).Conclusion The combined application of short-term CSII and sitagliptin will achieve a better effect than the combination with acarbose,can smoothly and steadily reduces the blood glucose level,relieves the whole day glucose fluctuations,effectively reduces △ insulin,and has lower hypoglycemia occurrence rate.
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Objective To study the analysis of insulin glargine combined with acarbose in type 2 diabetes compared with pre mixed insulin treatment efficacy and safety. Methods 100 patients with type 2 diabetes mellitus treated in our hospital from March 2015 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group were treated with premixed insulin treatment, the experimental group were treated with basal insulin combined with acarbose. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the fasting blood glucose level of the control group was (7.56 ± 1.13) nmol / L, and the fasting blood glucose level of the experimental group was (7.01 ± 0.92) nmol / L. The level of fasting blood glucose in the experimental group was significantly lower than that in the control group, with statistical difference (P<0.05). The level of HbA1c in the experimental group was (7.01 ± 0.82)％, significantly lower than that in the control group, and the level of HbA1c (7.45 ± 0.91)％, with statistical difference (P<0.05). Among the 50 patients in the control group, hypoglycemia occurred in 20 patients, the incidence of hypoglycemia was 40％, significantly higher than that in the experimental group, and the incidence of hypoglycemia was 14％, which was statistically significant (P<0.05). Conclusion Basal insulin combined with acarbose compared with premixed insulin treatment of type 2 diabetes treatment can significantly hypoglycemic effect, high safety, with further clinical promotion and application significance.
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Objective To investigate the efficacy and side effects of acarbose and metformin in the treatment of type 2 diabetes mellitus. Methods 100 patients with type 2 diabetes mellitus's choice of the January 2015 to March 2017 in our hospital, the patients were randomly divided into two groups: the control group was treated with metformin, acarbose treatment in observation group; the two groups before and after treatment of blood glucose control, the adverse reaction condition of comprehensive observation, will be granted the relevant data recorded and analyzed. Results Patients with fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin improvement than the control group, the difference was statistically significant (P<0.05); two groups of patients with adverse reaction rate comparison, the difference was not statistically significant. Conclusion Patients with type 2 diabetes choose acarbose treatment effect significantly, can effectively improve the patients fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin, clinical symptoms of patients can be improved, low incidence of adverse reactions.
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Objective To study the effects of acarbose combined with metformin in the treatment of newly diagnosed type 2 diabetes mellitus and its effects on levels of glycosylated hemoglobin and serum cystatin C.Methods 76 patients with newly diagnosed type 2 diabetes mellitus were divided into observation group and control group according to the order of admission.The control group was treated with metfonnin,the observation group was treated with acarbose combined with metformin.The levels of blood glucose and serum cystatin C before and after treatment in the two groups were compared.The clinical efficacy and side effects were analyzed.Results After treatment,the total effective rate in the observation group was significantly higher than that in the control group[89.47％ (34/38) vs.63.16％ (24/38)] (x2 =7.280,P ＜ 0.05).After treatment,the levels of glycosylated hemoglobin,postprandial blood glucose,fasting blood glucose and serum cystatin C in the observation group were significantly lower than those in the control group[(6.78 ±0.81)％,(7.01 ±0.22)mmol/L,(5.12 ±0.32)mmol/L,(0.82 ±0.11)mg/L vs.(7.99 ±0.85) ％,(9.49 ± 0.61) mmol/L,(7.32 ± 0.54) mmol/L,(1.41 ± 0.22) mg/L] (t =6.353,23.576,21.606,14.787,all P ＜ 0.05).There was no significant difference in the incidence rate of adverse reaction between the observation group and the control group [15.79％ (6/38) vs.13.16％ (5/38)] (x2 =0.106,P ＞ 0.05).Conclusion Acarbose combined with metformin can effectively reduce the levels of glycated hemoglobin and serum cystatin C in patients with newly diagnosed type 2 diabetes mellitus.The clinical efficacy is good and the adverse reaction rate is low.
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OBJECTIVE:To observe the effects of sitagliptin phosphate combine with acarbose on blood glucose,blood lipid and the serum glucose transporter 4(GLUT4)in elderly patients with type 2 diabetes. METHODS:86 elderly patients with type 2 diabetes were randomly divided into control group and observation group,43 cases in each group. All patients received guidance about diet,exercise and living habits,etc.,as well as the care about psychology and medication. Based on it,control group was given Acarbose tablet 50 mg/times,tid,chewing when a meal;observation group was given Acarbose tablet(the same dosage and usage)+ Sitagliptin phosphate tablet 100 mg/times,qd,orally. They were treated for 3 months. Fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbAlc),body mass index(BMI),fasting insulin(FINs),insulin resistance index(HOMA-IR),islet B-cell function index(HOMA-B),total cholesterol(TC),triglyceride(TG),low-density lipo-protein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)before and after treatment in 2 groups were compared, the incidence of adverse reactions was recorded. Other 43 healthy people were selected as healthy control group,the differences of serum GLUT4 levels before and after treatment between the 2 groups and healthy control group were respectively compared. RE-SULTS:After treatment,the BMI,FBG,2 hPG,HbAlc,HOMA-IR,FINs,TC,TG and LDL-C level were significantly lower than before,observation group was lower than control group;HOMA-B and HDL-C level were significantly higher than before,ob-servation group was higher than control group,with statistical significance(P0.05),while the serum GLUT4 level in observation group was significant higher than before and control group;and the serum GLUT4 level in 2 groups were still significant lower than healthy control group(P0.05). CON-CLUSIONS:Sitagliptin phosphate combine with acarbose can effectively control patients'blood glucose and lipid levels in the treatment of elderly patients with type 2 diabetes,improve HOMA-B and serum GLUT4 level,and does not increase the incidence of adverse reactions,with good safety.
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Objective To observe the acarbose combined therapy with sugar pulse phase Ⅰ and phase Ⅱ clinical curative effect of diabetic nephropathy and the effects of oxidative stress on the patients.Methods 188 cases of phase Ⅰ and phase Ⅱ DN patients were selected in hangzhou xixi hospital endocrinology from January 2012 to December 2012,randomly divided into control group and treatment group,94 cases in each groups,the control group given conventional western medicine treatment of diabetic nephropathy,antihypertensive agents using lotensin.Treatment group was treated in the control group on the basis of taking acarbose and sugar pulse tablet.The control group and treatment group a course of eight weeks.Testing for 48 hours patients before and after the urine trace albumin in the urine(UAER)and creatinine ratio(ACR)with urine trace albumin,serum oxide dismutase(SOD),catalase(CAT)and malondialdehyde(MDA).Results The total effective rate was 91.5％in the treatment group,which was significantly higher than that in the control group(68.1％),the total effective rate of the two groups was statistically significant(P<0.05); The levels of UAER and ACR in the treatment group were lower than those in the control group(P<0.05); After treatment,the levels of serum SOD and CAT in the treatment group were higher than those in the control group,the MDA level was lower than that in the control group,the difference was statistically significant(P<0.05); No adverse reactions occurred in the two groups.Conclusion Acarbose combined with Tangmaikang granules in the treatment of DN patients with significant effect,can improve the treatment of diabetic nephropathy,the levels of oxidative stress injury is related to diabetic nephropathy mechanism.