Effects of Acarbose in Metabolic Control of Patients with Type 1 Diabetes Mellitus

A carbose is a reversible inhibitor of the intestinal alpha-glucosidases, the oral administration of which delays absorption of carbohydrates. The aim of this study was to investigate the effect of administration of acarbose on parameters of gly-caemic control, lipid parameters and tolerability in ambulant type 1 diabetic subjects. Materials and Methods: Entry criteria included being: diabetic, age below 30 years and a history of at least one episode of diabetic ketoacidosis insufficiently controlled with diet and insulin. The data of 17 patients (6 men and 11 women, mean age 17.2±3.5 (range 14–26) years, median duration of diabetes 8 (range 1–20) years were valid for statistical analysis. Results: During the run-in period HbA1c levels tended to decrease from 9.5±1.1 to 9±1.7%. After 12 weeks of acarbose treatment, the mean level had decreased further to 7.6±1.6% (P: 0.002). Af-ter discontionuing acarbose, HbA1c levels in-creased to a mean level of 8.8±0.9%. A significant reduction in Fasting Plasma Glucose (FPG) (from 195±62 to 139±73 mg/dL, P<0.01) and 2 hour post prandial glucose (2 hppG) was observed with acarbose (from 231±82 to 159±72 mg/dL, P<0.001). Reduction in total cholesterol (from 159±36 to 146±26 mg/dL, p: 0.09) and triglycerides (from100±22 to 81±23 mg/dL, p: 0.02) was de-tected after treatment with acarbose. No signifi-cant changes were observed in HDL cholesterol. The most frequent reported adverse events were flatulence (7 subjects) and mild abdominal pain (2 subjects). Conclusion: We conclude that acarbose up to 3×100 mg/day can be a valuable adjunct to insu-lin in improving metabolic control in persons with type 1 diabetes