期刊
DIABETES & VASCULAR DISEASE RESEARCH
卷 9, 期 3, 页码 163-169出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/1479164112441524
关键词
Alpha-glucosidase inhibitors; postprandial hyperglycaemia; glycaemic variability; myocardial infarction; STOP-NIDDM Trial; Acarbose Evaluation Trial
资金
- Association for the Support of International Scientific Communication in Diabetology e.V., Munich, Germany
- Astra Zenica
- Bayer
- BMS
- GSK
- Johnson Johnson
- Lilly
- Menarini
- Merck-Serono
- MSD/Merck
- Novartis
- NovoNordisk
- Rambaxi
- Roche
- Sanofi-Aventis
- Servier
- Takeda
- Bayer Schering Pharma
Alpha-glucosidase inhibitors have been available for clinical use for about 20 years. They have shown reasonably good efficacy comparable to other oral blood glucose lowering drugs and in some parts of the world are the most commonly prescribed oral diabetes medication, especially in Asian countries. Unlike as has been observed with some other blood glucose lowering agents, however, no adverse signals of potential cardiovascular harm have emerged in relation to their use. On the contrary, significant beneficial cardiovascular outcome results have been observed in the post-hoc analyses of randomised placebo-controlled trials with the alpha-glucosidase inhibitor acarbose. Targeting mainly postprandial hyperglycaemia, alpha-glucosidase inhibitors favourably affect several cardiovascular risk factors, such as obesity, hypertension and high glycaemic variability with little to no risk for hypoglycaemia. Furthermore, acarbose favourably affects endothelial dysfunction and carotid intima media thickening in humans and, in animal models, improves cardiac interstitial fibrosis and hypertrophy of cardiomyocytes. The ultimate determination of the cardiovascular effects of alpha-glucosidase inhibitors in terms of clinical outcomes awaits the results of ongoing long-term, randomised, placebo-controlled trials.
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