Improvement In Blood Glucose Fluctuations Of Insulin-treated Diabetic Patients With Addition Of Acarbose, As Assessed By Continuous Blood Glucose Monitoring

Objective To investigate whether adding acarbose to intensive insulin therapy would reduce blood glucose fluctuations in type 1 and type 2 diabetic patients who had unstable plasma glucose profiles. Method Following addition of acarbose to insulin treatment, patients were assessed by continuous blood glucose monitoring for 72 hours. Pre and post-acarbose measurements of parameters for blood glucose fluctuation were analysed and compared. Result In all patients, acarbose significantly reduced parameters (p<0.001 for most parameters) for measuring blood glucose fluctuation, including mean daily deviations in glucose, postprandial glucose fluctuations and excursions, and hyperglycaemia. Acarbose 150 and 300 mg/day were superior to acarbose 75 mg/day and to pre-treatment; the most effective dose was 150 mg daily. Acarbose also significantly reduced (p<0.05) the incidence, amplitude and duration of hypoglycaemia (especially nocturnal), and the insulin dose required (p<0.05). Conclusion When added to insulin, acarbose significantly improved blood glucose fluctuations for all patients within 72 hours of dosing. This treatment strategy may reduce the risk of micro- and macrovascular complications in type 1 and type 2 diabetic patients with unstable blood glucose profiles despite intensive insulin therapy.