An open-label prospective cross-over trial was performed to compare the efficacy and adverse effects of
nateglinide with those of
voglibose on Japanese early
type 2 diabetes (who were oral
hypoglycemic agent naïve and whose HbA(1C) levels were between 7.0 and 7.9% before treatment). Fourteen patients received 270 mg/day of
nateglinide and 15 patients received 0.6 mg/day of
voglibose. After 12 weeks of either
therapy, the drugs were switched and treatment was continued for another 12 weeks. After 3-month treatment with each drug, HbA(1C) value decreased significantly (baseline HbA(1C) 7.24 +/- 0.42%, 6.70 +/- 0.47% with
nateglinide: p<0.01, 6.93 +/- 0.62% with
voglibose: p<0.05) but the difference in the effect between
nateglinide and
voglibose was not significant (p = 0.121). Symptoms related to
hypoglycemia (e.g., increased appetite, palpitation, sweating,
tremor) were scarcely observed with either
voglibose or
nateglinide treatments. Abdominal fullness/borborygmi was frequently reported, with variable severity, by patients on
voglibose but this was absent or mild in those on
nateglinide. After completion of both arms of the study, more patients favored
nateglinide than
voglibose. Our results suggest that
nateglinide is an effective and safe drug in the treatment of early
type 2 diabetes, similar to
voglibose.