Weight Reduction Effect Of Acarbose And Metformin In Newly Diagnosed Type 2 Diabetes

objective:The Metformin and Acarbose in Chinese as the initial Hypoglycemic treatment (MARCH) study found that acarbose and metformin had similar efficacy in HbAl creduction and weight loss after 48 weeks of treatment.The MARCH study also found that GLP-1 levels were elevated by acarbose and metformin treatment. We use data from MARCH to investigate whether the change in levels of endogenous GLP-1 was associated with weight loss in patients newly diagnosed with type 2 diabetes.Methods:The 784 subjects of MARCH were stratified by the level of change in GLP-1 levels (pmol/ml·min) after 24 and 48 weeks of therapy into of low(<45 and <101.4, respectively), medium (45-2144and 101.4-2310.75), and large (>2144 and>2310.75)changes for the entire patient population; into low(<32 and<-12.9), medium (32-2054and-12.9-2257.05), and large (>2054and>2257.05) changes for the acarbose treatment group; and low(<72and< 287.55), medium (72-2208, and 287.55-2406.9) and large (>2208and>2406.9) changes for the metformin treatment group. We evaluated changes in clinical and physiological parameters from baseline across the GLP-1 subgroups and performed multivariate linear analysis to assess the correlation between GLP-1 levels and weight loss following therapy with the two drugs.Results:Larger changes in GLP-1 levels from baseline were associated with greater weight loss and reduction in BMI in the total study population after 24 weeks of therapy, and greater reduction in glucagon AUC after 48 weeks of treatment. Greater changes in GLP-1 levels were also associated with larger decreases in weight, BMI, and fasting plasma glucose (FPG) at Week 24 in the acarbose treatment group. Multivariate linear regression analysis found that for the total population, gender, baseline BMI, and changes in GLP-1 levels at Week 24 were associated with weight loss, especially in groups with medium and high changes in GLP-1 from baseline. For the different treatment groups, BMI and large changes in GLP-1 levels in acarbose group and BMI in metformin group were predictive of weight loss at Week 24. BMI and gender at Week 48 were predictive of weight loss for the entire study population and each treatment group.Conclusions:In this subgroup analysis, greater changes from baseline in GLP-1 levels were associated with larger weight loss in type 2 diabetes patients after 24 weeks of acarbose treatment. GLP-1level may play an important role regulating body weight reduction after acarbose treatment in Chinese patients with newly diagnosed type 2 diabetes.