Abstract
The effect of combination therapy consisting of an α-glucosidase inhibitor (acarbose) and conventional insulin therapy was evaluated in 19 non-insulin-dependent diabetic patients. The blood glucose levels of these elderly inpatients (72±7 years-old) were fairly controlled after a pretreatment period with conventional insulin therapy alone. Acarbose was administered orally immediately before each meal for 4 weeks. It significantly reduced postprandial blood glucose levels (after breakf ast: 210±45mg/dl to 166±41mg/dl, P<0.01, after lunch: 219±48 to 168±61, P<0.001, after dinner: 237±49 to 174±63, P<0.001), and this was accompanied by a signif icant decrease in HbA1c (8.6±1.7%to7.4±0.7%, P<0.001) and a significant increase in serum 1, 5-anhydroglucitol (4.8±3.5μg/mlto 6.1±2.4μg/ml, P<0.05). Serum C-peptide levels 2 hours after breakfast were significantly decreased after 4 weeks of combined therapy (3.8±2.1ng/ml to 3.2±1.9ng/ml, P<0.02), whereas serum C-peptide levels before breakfast were unaffected. These results indicate that an a-glucosidase inhibitor such as acarbose has a beneficial effect on postprandial hyperglycemia and postprandial hyperinsulinemia in NIDDM patients treated with conventional insulin therapy.
