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Horm Metab Res 2009; 41(2): 104-108
DOI: 10.1055/s-0028-1103276
Original

© Georg Thieme Verlag KG Stuttgart · New York

Effects of the Alpha Glucosidase Inhibitor Acarbose on Endothelial Function after a Mixed Meal in Newly Diagnosed Type 2 Diabetes

F. Pistrosch 1 , F. Schaper 2 , J. Passauer 1 , C. Koehler 2 , S. R. Bornstein 1 , M. Hanefeld 2
  • 1Department of Medicine, Technical University of Dresden, Dresden, Germany
  • 2Center of Clinical Studies, Technical University, Dresden, Germany
Further Information

Publication History

received 23.08.2008

accepted 28.10.2008

Publication Date:
05 December 2008 (online)

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Abstract

Endothelial dysfunction (ED) has been suggested as a possible causal link between postprandial hyperglycemia and cardiovascular events in patients with type 2 diabetes. Recent trials demonstrated a reduction of cardiovascular events by treatment with α-glucosidase inhibitor acarbose – a drug which mainly reduces postprandial glucose excursions. We were interested to know whether patients with newly diagnosed type 2 diabetes showed postprandial ED and if so whether acarbose was able to improve this condition. Forearm blood flow (FBF) measurements for assessment of ED were performed in the fasting and postprandial state in 20 newly diagnosed type 2 diabetic patients and 10 healthy control subjects. After baseline examination, patients were randomly assigned to a 20-week treatment of acarbose 100 mg t.i.d or matching placebo, thereafter FBF measurements were repeated. FBF of patients in the fasting state was significantly impaired compared to healthy control subjects (max. FBF 5.3±0.7 vs. 8.0±0.9 ml/100 ml, p<0.02) and did not change in the postprandial state (max. FBF 5.6±0.7 ml/100 ml). In contrast, healthy controls showed a significant improvement of FBF in the postprandial state (11.5±1.2 ml/100 ml), which is compatible with postprandial ED in the group of patients. Twenty weeks of acarbose treatment did not affect either fasting or postprandial FBF in patients. Early type 2 diabetes is a state of both fasting and postprandial ED, which is not sensitive to acarbose treatment. Protective cardiovascular effects of acarbose might involve other mechanisms.

Key words

forearm blood flow - endothelial dysfunction - postprandial - type 2 diabetes - acarbose

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Correspondence

F. Pistrosch

Nephrology/Endocrinology & Diabetes

Universitätsklinik “Carl Gustav Carus”

Fetscherstr. 74

01307 Dresden

Germany

Phone: +49/351/458 35 10

Fax: +49/351/458 53 55

Email: frankpistrosch@hotmail.com