Acarbose - An update of its therapeutic use in diabetes treatment

Oral antidiabetic drugs are becoming increasingly important as rates of type 2 diabetes, uncontrolled by dietary intervention alone, increase around the world. Therapeutic agents that target the early stages of type 2 diabetes, such as the a-glucosidase enzyme inhibitor acarbose, which reduces postprandial hyperglycaemia and hyperinsulinaemia, now have a more prominent role to play in diabetes management in view of increasing evidence that the postprandial state is an important contributing factor to the development of atherosclerosis. This review provides an update on the role of acarbose in present-day diabetes care. Acarbose is a first-line treatment for newly diagnosed patients with type 2 diabetes, those who have high postprandial blood glucose and for patients where dietary treatment alone provides inadequate glycaemic control. Acarbose lowers blood glucose when administered as monotherapy and in combination with other oral antidiabetic drugs. It reliably reduces levels of glycated haemoglobin (HbA(1c)) and also increases insulin sensitivity; however, unlike insulin and the sulphonylureas, acarbose has not been associated with bodyweight gain. The aim of this review is to present clinical data on the pharmacology and efficacy of acarbose in the treatment of patients with type 2 diabetes mellitus. It is not intended to present a comprehensive review of the treatment of diabetes mellitus in general.