Acarbose compared with metformin as initial therapy in patients with newly diagnosed type 2 diabetes: an open-label, non-inferiority randomised trial

2014 ◽  
Vol 2 (1) ◽  
pp. 46-55 ◽  
Author(s):  
Wenying Yang ◽  
Jie Liu ◽  
Zhongyan Shan ◽  
Haoming Tian ◽  
Zhiguang Zhou ◽  
...  
2012 ◽  
Vol 167 (2) ◽  
pp. 287-294 ◽  
Author(s):  
Leo Niskanen ◽  
Lawrence A Leiter ◽  
Edward Franek ◽  
Jianping Weng ◽  
Taner Damci ◽  
...  

ObjectiveInsulin degludec/insulin aspart (IDegAsp) is a soluble co-formulation of insulin degludec (70%) and insulin aspart (IAsp: 30%). Here, we compare the efficacy and safety of IDegAsp, an alternative IDegAsp formulation (AF: containing 45% IAsp), and biphasic IAsp 30 (BIAsp 30).DesignSixteen-week, open-label, randomised, treat-to-target trial.MethodsInsulin-naive subjects with type 2 diabetes (18–75 years) and a HbA1c of 7–11% were randomised to twice-daily IDegAsp (n=61), AF (n=59) or BIAsp 30 (n=62), all in combination with metformin. Insulin was administered pre-breakfast and dinner (main evening meal) and titrated to pre-breakfast and pre-dinner plasma glucose (PG) targets of 4.0–6.0 mmol/l.ResultsMean HbA1c after 16 weeks was comparable for IDegAsp, AF and BIAsp 30 (6.7, 6.6 and 6.7% respectively). With IDegAsp, 67% of subjects achieved HbA1c <7.0% without confirmed hypoglycaemia in the last 4 weeks of treatment compared with 53% (AF) and 40% (BIAsp 30). Mean fasting PG was significantly lower for IDegAsp vs BIAsp 30 (treatment difference (TD): −0.99 mmol/l (95% confidence interval: −1.68; 0.29)) and AF vs BIAsp 30 (TD: −0.88 mmol/l (−1.58; −0.18)). A significant, 58% lower rate of confirmed hypoglycaemia was found for IDegAsp vs BIAsp 30 (rate ratio (RR): 0.42 (0.23; 0.75)); rates were similar for AF vs BIAsp 30 (RR: 0.92 (0.54; 1.57)). IDegAsp and AF had numerically lower rates of nocturnal confirmed hypoglycaemia vs BIAsp 30 (RR: 0.33 (0.09; 1.14) and 0.66 (0.22; 1.93) respectively).ConclusionsIDegAsp provided comparable overall glycaemic control to BIAsp 30 with a significantly lower rate of hypoglycaemia.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jia Liu ◽  
Yanjin Hu ◽  
Yuan Xu ◽  
Yumei Jia ◽  
Li Miao ◽  
...  

Aims. The present study assessed the therapeutic effect of exenatide and metformin as the initial therapy on overweight/obese patients with newly diagnosed type 2 diabetes (T2D). Methods. The prospective, nonrandomized, interventional study enrolled a total of 230 overweight or obese patients with newly diagnosed T2D who were administrated exenatide or metformin hydrochloride for 12 weeks. Results. 224/230 patients, including 106 in the exenatide group and 118 in the metformin group, completed the 12-week treatment. Both exenatide and metformin significantly decreased the HbA1c levels in overweight/obese patients with newly diagnosed T2D (all P<0.05). The reduction in HbA1c and the proportion of patients with HbA1c < 7.0% (53 mmol/mol) were higher in the exenatide group than in the metformin group (all P<0.05). The exenatide treatment caused a greater decline in the body weight and BMI as compared to the metformin treatment (all P<0.01). The exenatide treatment (β = 0.41, P<0.01) and baseline HbA1c level (β = −0.84, P<0.01) were independent influencing factors for the decrease in HbA1c level. Conclusions. For an initial therapy in overweight/obese patients with newly diagnosed T2D, exenatide causes a better glycemic control than metformin. This trial is registered with NCT03297879.


Author(s):  
Ram A. Manda ◽  
Veena Verma ◽  
Krishna Biswas

Background: Type 2 DM is one global health problem and a main cause of morbidity and mortality. It is epidemic in many industrialized and developing areas and is considered to be one of the most challenging health problems of the 21st century. Metformin and acarbose both are used as monotherapy and in combination with other anti-diabetes drugs for treatment of type 2 DM. There are very sparse evidences regarding comparative efficacy and safety of metformin versus acarbose, especially in Asian region. In addition to glycemic control, improvement in lipid profile, weight loss and post-prandial sugar level are important therapeutic objectives for better management of type 2 DM patients.Methods: In this study, 60 newly diagnosed type 2 DM were randomly assigned (1:1) to oral acarbose (titrated doses upto 300 mg daily) or oral metformin (titrated doses up to 2500 mg daily) monotherapy and were followed-up for 12 weeks for effects on glycaemic control [serum HbA1C, fasting blood sugar and post prandial sugar and serum LDL, HDL, triglycerides and total cholesterol.Results: Reduction in FBS, HbA1C and body weight was found significantly greater with metformin while acarbose yielded greater improvement in PPS, total cholesterol and triglyceride levels. Both metformin and acarbose yielded significant improvement in FBS, PPS, HbA1C, lipid profile and body weight after 12 weeks of therapy and yielded similar improvement in LDL and HDL levels.Conclusions: Acarbose can be considered as an alternative initial therapy in newly diagnosed type 2 diabetes patients, particularly those with isolated post-prandial hyperglycemia and those who are intolerant to metformin therapy. 


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