Rudovich, Natalia N., Weickert, Martin O., Pivovarova, Olga, Bernigau, Wolfgang and Pfeiffer, Andreas F. H.. (2011) Effects of acarbose treatment on markers of insulin sensitivity and systemic inflammation. Diabetes Technology & Therapeutics, Vol.13 (No.6). pp. 615-623. ISSN 1520-9156

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Abstract

Background: This study assessed the effect of postprandial glucose reduction by acarbose on insulin sensitivity and biomarkers of systemic inflammation.

Methods: This was a single-center, double-blind, randomized, placebo-controlled, crossover study <40 weeks in duration, involving 66 subjects with varying degrees of glucose tolerance. Eligible patients completed a 3-week run-in period and were randomized to receive either 100 mg of acarbose three times daily followed by placebo, or vice versa, lasting 12 weeks each with a 12-week washout between interventions. Liquid meal challenges and hyperinsulinemic-euglycemic glucose clamp were performed at weeks 0, 12, 24, and 36.

Results: Fasting proinsulin levels and proinsulin-to-adiponectin ratios but not fasting adiponectin levels were significantly lower during acarbose versus placebo treatment. Clamp-derived insulin sensitivity index and body weight were unchanged by the intervention. Levels of fasting insulin, fasting glucose, monocyte chemoattractant protein-1, interleukin-6, and interleukin-1 beta were comparable between treatments. In the liquid meal challenge tests, postprandial glucose and insulin responses were significantly lower during acarbose versus placebo treatment. The effects of acarbose on the reduction of fasting proinsulin was most pronounced in subjects with impaired fasting glucose/impaired glucose tolerance (n = 24).

Conclusions: Reduction of the glycemic load by acarbose decreased fasting levels of proinsulin but had no effect on adiponectin and whole-body insulin sensitivity as well as biomarkers reflecting inflammation. The preventive effects of acarbose on type 2 diabetes mellitus and cardiovascular risk need further investigation and cannot be explained by changes of insulin resistance and inflammatory biomarkers.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine R Medicine > RM Therapeutics. Pharmacology
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Non-insulin-dependent diabetes -- Patients, Cardiovascular system -- Diseases, Heart -- Diseases, Hyperglycemia, Insulin resistance, Acarbose
Journal or Publication Title:	Diabetes Technology & Therapeutics
Publisher:	Mary Ann Liebert, Inc. Publishers
ISSN:	1520-9156
Official Date:	June 2011
Dates:	Date Event June 2011 Published
Volume:	Vol.13
Number:	No.6
Page Range:	pp. 615-623
Identification Number:	10.1089/dia.2010.0235
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Germany. Bundesministerium für Bildung und Forschung (BMBF), Bayer Vital GmbH
Grant number:	MGP 0313042C/ NR (BMBF)
URI:	http://wrap.warwick.ac.uk/id/eprint/39969

Data sourced from Thomson Reuters' Web of Knowledge

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