Comparative assessment of the efficacy and safety of acarbose and metformin combined with premixed insulin in patients with type 2 diabetes mellitus

Honghua Wu, Jie Liu, Qingqing Lou, Jing Liu, Li Shen, Mingxia Zhang, Xiaofeng Lv, Mingjun Gu, Xiaohui Guo, Honghua Wu, Jie Liu, Qingqing Lou, Jing Liu, Li Shen, Mingxia Zhang, Xiaofeng Lv, Mingjun Gu, Xiaohui Guo

Abstract

This study, a subgroup analysis of the data from the Organization Program of DiabEtes INsulIN ManaGement study, aimed to compare the efficacy and safety profiles of acarbose and metformin used in combination with premixed insulin.This analysis included 80 and 192 patients taking only 1 oral antidiabetic drug, classified into acarbose (treated with acarbose + insulin) and metformin groups (treated with metformin + insulin), respectively. The efficacy and safety data were analyzed for within- and between-group differences. The clinical trial registry number was NCT01338376.The percentage of patients who achieved target hemoglobin A1c (HbA1c) <7% in the acarbose and metformin groups were 38.75% and 30.73%, respectively, after a 16-week treatment. The average HbA1c levels in the acarbose and metformin groups were comparable at baseline and decreased significantly in both groups at the end of the study. All 7 blood glucose decreased significantly in both groups at endpoint compared with that at baseline. Insulin consumption was higher in the metformin group in terms of total daily amount and units/kg body weight. Incidences of hypoglycemia were similar in both groups. Body weight changed significantly in both groups from baseline to endpoint, but with no significant difference between the groups. Mean scores of Morisky Medication Adherence Scale improved in both groups at endpoint.Combination of insulin with acarbose or metformin could improve glycemic control in patients with type 2 diabetes mellitus. Acarbose and metformin were found to be comparable in terms of efficacy, weight gain, and incidence of hypoglycemia.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Participant inclusion and exclusion processes. Aca = acarbose, Ins = premixed insulin, Met = metformin.
Figure 2
Figure 2
Comparison of blood glucose levels at 7 time points before and after the treatment between the treatment groups. ∗P < .05 compared with the metformin group.

References

    1. Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China. N Engl J Med 2010;362:1090–101.
    1. Guo XH, Ji LN, Lu JM. Glycemic control of adult patients with type 2 diabetes mellitus treated by oral antidiabetic drugs in combination with insulin in China in 2009. Chin J Diabetes Mellitus 2012;4:474–8.
    1. Ji LN, Lu JM, Guo XH, et al. Status of blood glucose control and treatment of type 2 diabetes in China. Chin J Diabetes Mellitus 2012;4:397–401.
    1. Lu JM, Ji LN, Guo XH. Glycaemic control in patients with type 2 diabetes treated with oral antidiabetic drugs in urban areas of China. Chin J Diabetes Mellitus 2012;4:402–6.
    1. Li S, Xiao J, Ji L, et al. BMI and waist circumference are associated with impaired glucose metabolism and type 2 diabetes in normal weight Chinese adults. J Diabetes Complications 2014;28:470–6.
    1. Xiao J, Weng J, Ji L, et al. Worse pancreatic beta-cell function and better insulin sensitivity in older Chinese without diabetes. J Gerontol A Biol Sci Med Sci 2014;69:463–70.
    1. Yang W, Liu J, Shan Z, et al. Acarbose compared with metformin as initial therapy in patients with newly diagnosed type 2 diabetes: an open-label, non-inferiority randomised trial. Lancet Diabetes Endocrinol 2014;2:46–55.
    1. Ma RC, Lin X, Jia W. Causes of type 2 diabetes in China. Lancet Diabetes Endocrinol 2014;2:980–91.
    1. Li Y, Tong Y, Zhang Y, et al. Acarbose monotherapy and weight loss in Eastern and Western populations with hyperglycaemia: an ethnicity-specific meta-analysis. Int J Clin Pract 2014;68:1318–32.
    1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014;37(suppl):s81–91.
    1. Task Force on diabetes, pre-diabetes, cardiovascular diseases of the European Society of Cardiology, European Association for the Study of Diabetes, et al.. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: summary. Diab Vasc Dis Res 2014;11:133–73.
    1. Society CD. Diagnosis and treatment of type 2 diabetes mellitus in China. Chin J Diabetes Mellitus 2013;6:447–99.
    1. Ma RC. Acarbose: an alternative to metformin for first-line treatment in type 2 diabetes? Lancet Diabetes Endocrinol 2014;2:6–7.
    1. Chen M, Dou J, Zhuang X, et al. An analysis of hypoglycemic agents used among patients with type 2 diabetes in Beijing communities. Zhonghua Nei Ke Za Zhi 2014;53:112–5.
    1. Lin SD, Wang JS, Hsu SR, et al. The beneficial effect of alpha-glucosidase inhibitor on glucose variability compared with sulfonylurea in Taiwanese type 2 diabetic patients inadequately controlled with metformin: preliminary data. J Diabetes Complications 2011;25:332–8.
    1. Guo XH, Ji LN, Lu JM, et al. Efficacy of structured education in patients with type 2 diabetes mellitus receiving insulin treatment. J Diabetes 2014;6:290–7.
    1. Ji L, Lu J, Weng J, et al. China type 2 diabetes treatment status survey of treatment pattern of oral drugs users. J Diabetes 2015;7:166–73.
    1. Gu S, Shi J, Tang Z, et al. Comparison of glucose lowering effect of metformin and acarbose in type 2 diabetes mellitus: a meta-analysis. PLoS One 2015;10:e0126704.

Source: PubMed

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