Treatment of impaired glucose tolerance with acarbose and its effect on intima-media thickness: a substudy of the STOP-NIDDM trial (study to prevent non-insulin-dependent diabetes mellitus).

Abstract

OBJECTIVE:

To discuss the influence of glucose excursions on intima-media thickness (IMT) and the potential benefits of treatment to reduce or reverse its effects on cardiovascular risk.

METHODS:

The findings in pertinent reported studies are reviewed, and the efficacy of various interventions for management of impaired glucose tolerance and type 2 diabetes in slowing the progression of IMT is analyzed.

RESULTS:

Considerable evidence from published epidemiologic studies provides compelling data regarding the association between postprandial and postchallenge glycemic excursions and cardiovascular risk. IMT has been shown to be a good surrogate marker for symptomatic and coronary atherosclerosis. Acarbose treatment in patients with impaired glucose tolerance has been shown to diminish the progression of IMT in comparison with placebo. In a study of repaglinide or glyburide therapy in patients with type 2 diabetes, a reduction in IMT was noted in the repaglinide group but not in the glyburide group at 1-year follow-up.

CONCLUSION:

Measurement of IMT allows direct observation of vascular damage attributable to postprandial and postchallenge hyperglycemia. It also provides a means for direct assessment of the effect of medications used for the control of glucose excursions.

• Authors: Markolf Hanefeld
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) 2006 Jan-Feb Vol. 12 Suppl 1 Pg. 56-9 ISSN: 1530-891X [Print] United States
• PMID: 16627382 (Publication Type: Journal Article, Review)

Chemical References

• Carbamates
• Hypoglycemic Agents
• Piperidines
• repaglinide
• Glyburide
• Acarbose

Topics

• Acarbose (therapeutic use)
• Carbamates (therapeutic use)
• Cardiovascular Diseases (etiology, pathology, prevention & control)
• Carotid Arteries (pathology)
• Diabetes Mellitus, Type 2 (complications, pathology, prevention & control)
• Glucose Intolerance (drug therapy)
• Glyburide (therapeutic use)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Piperidines (therapeutic use)
• Tunica Intima (drug effects, pathology)
• Tunica Media (drug effects, pathology)