Acarbose Monotherapy and Type 2 Diabetes Prevention in Eastern and Western Prediabetes: An Ethnicity-specific Meta-analysis.

Abstract

PURPOSE:

Acarbose is effective in delaying or preventing the progression of prediabetes to type 2 diabetes mellitus (T2DM). The aim of this study was to assess differences in the preventive effects of acarbose in Eastern and Western populations with prediabetes.

METHODS:

We performed a systematic search of databases and reference lists of clinical trials conducted through August 2013. Randomized controlled trials of acarbose alone, with a minimum intervention duration of 3 years and which provided data on T2DM incidence, were included for analysis. Analyses were conducted by using Review Manager version 5.1 software.

FINDINGS:

Eight randomized controlled trials with 2628 participants were included. Acarbose decreased the occurrence of T2DM (number needed to treat [NNT], 6.7). Compared with the control (placebo and/or lifestyle intervention), the incidence of T2DM was significantly lower in the Eastern group (NNT, 5.9) than in the Western group (NNT, 11.1) (P < 0.0001, I(2) = 94.7%). At the end of follow-up, reversal of prediabetes to normal glucose tolerance was more likely in the Eastern group (NNT, 4.3) than in the Western group (NNT, 25) (P = 0.004, I(2) = 92%). Among those remaining prediabetic, there was no significant difference between the subtotal estimates for the subgroups (P = 0.17, I(2) = 46.5%). There was no positive correlation between preventive effect and dose, and no difference in studies with varying follow-up durations within and across either ethnic group.

IMPLICATIONS:

The preventive effect of acarbose on the development of diabetes seems superior in Eastern populations with prediabetes compared with Western populations.

• Authors: Ruijie Hu, Yi Li, Qingguo Lv, Taixiang Wu, Nanwei Tong
• Journal: Clinical therapeutics (Clin Ther) Vol. 37 Issue 8 Pg. 1798-812 (Aug 2015) ISSN: 1879-114X [Electronic] United States
• PMID: 26118669 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Chemical References

• Glycoside Hydrolase Inhibitors
• Acarbose

Topics

• Acarbose (therapeutic use)
• Asia (epidemiology)
• Diabetes Mellitus, Type 2 (ethnology, prevention & control)
• Disease Progression
• Europe (epidemiology)
• Glycoside Hydrolase Inhibitors (therapeutic use)
• Humans
• Life Style
• North America (epidemiology)
• Prediabetic State (drug therapy, ethnology)