Comparison of acarbose and metformin as add-on therapy to insulin in uncontrolled patients with type 2 diabetes mellitus: A randomized,openlabeled,and parallel group study  

作　　者：ZHANG Qiongge 张琼阁(Dept Endocrinol,Shanghai Changzheng Hosp,2nd Milit Med Univ)

机构地区：[1]Dept Endocrinol,Shanghai Changzheng Hosp,2nd Milit Med Univ

出　　处：《China Medical Abstracts(Internal Medicine)》2018年第4期210-211,共2页中国医学文摘（内科学分册（英文版）

摘　　要：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(Hb A1 C 7.5%-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 HbA1 C,oral glucose tolerance test,blood lipids etc were measured at baseline and 12 weeks,and adverse events were recorded.Results The mean HbA1 C levels decreased from(7.9±0.4)% at baseline to(7.0±0.3)% at week 12(P<0.01)in the Ins + Aca group and(7.8±0.2)% to(7.0±0.3)% in the Ins + Met group(P<0.01),while no significant change in HbA1 C in the insulin alone group was found.Adding acarbose to insulin resulted in similar reductions in HbA1 C relative to metformin(P=0.431).The achievement rate of Hb A1 C below 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 in combination with metformin(P<0.01),with standard deviation(SD)of blood glucose [(1.1±0.5 vs 2.7±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 maximum blood glucose fluctuations [(2.8±0.7 vs 4.6±0.6)mmol/L,P<0.01].The weight loss occurred in both the Ins + Aca and the Ins + Met groups [-(0.5±0.8 vs 1.0±0.4)kg].There was no significant changes in blood pressure and lipid profile.Hypoglycemic episodes were comparable in all groups.No serious adverse event was noted in any group.Conclusion Adding acarbose of metformin to insulin therapy could achieve improvements in glycemic control with similar reductions in Hb A1 C levels and weight,when comparing wit

关 键 词：METFORMIN INSULIN effect was INS Aca Met vs 

分 类 号：R587.1[医药卫生—内分泌]