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March 24, 2010Cardiovascular DiabetologyOpen Access

Postprandial endothelial dysfunction in subjects with new-onset type 2 diabetes: an acarbose and nateglinide comparative study

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Key result

Acarbose significantly improved postprandial endothelial function compared to control in patients with newly diagnosed type 2 diabetes, with postprandial flow-mediated dilation of 6.8% vs 5.2% (p=0.0022).

Why the study?

Does acarbose improve postprandial endothelial dysfunction compared to nateglinide or no medication in patients with newly diagnosed type 2 diabetes?

Population

30 patients with newly diagnosed type 2 diabetes. Excluded: smokers, history of cardiovascular disease, and…

Comparison

Acarbose 300 mg/day for 12 weeks vs Nateglinide 270 mg/day for 12 weeks, or no…

Design

RCT, randomly assigned to receive one of the following treatments, open-label

Follow-up

12 weeks

Authors

TKToru KatoTITeruo InoueKNKoichi Node

Discussion

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Member takes

Overview

Acarbose may be favored over nateglinide for postprandial endothelial protection in new T2D; extends RCT evidence for alpha-glucosidase inhibitors on vascular surrogates.

Study Design

Type

RCT (n=30)

Blinding

Open-label

Randomization

Randomly assigned

Structured PICO

Does acarbose improve postprandial endothelial dysfunction compared to nateglinide or no medication in patients with newly diagnosed type 2 diabetes?

P
Population
30 patients with newly diagnosed type 2 diabetes, mean age 67.8 years, randomized to acarbose, nateglinide, or no medication and followed for 12 weeks.
I
Intervention
Acarbose 300 mg/day for 12 weeks
C
Comparator
Nateglinide 270 mg/day for 12 weeks, or no medication (control group)
O
Outcome
Postprandial endothelial function assessed by % flow-mediated dilation (FMD) of the brachial artery at 0 and 120 min after cookie loadsurrogate

Main Result

Absolute Event Rate: 6.8% vs 5.2%

p-value: p=0.0022

Acarbose improves postprandial endothelial function more effectively than nateglinide in patients with newly diagnosed type 2 diabetes, likely by reducing postprandial hyperglycemia without increasing insulin secretion.

Limitations

  • Small sample size
  • Open-label study design
  • Did not assess triglyceride levels during the cookie test

Cite This Study

Kato et al. (2010) conducted an RCT in Newly diagnosed type 2 diabetes (n=30). Acarbose vs. No medication (control) or nateglinide 270 mg/day was evaluated on Postprandial flow-mediated dilation (FMD) of the brachial artery at 120 min after cookie load (p=0.0022). Acarbose significantly improved postprandial endothelial function compared to control in patients with newly diagnosed type 2 diabetes, with postprandial flow-mediated dilation of 6.8% vs 5.2% (p=0.0022).

synapsesocial.com/papers/6a9ada004b53eacbbcfc6737https://doi.org/10.1186/1475-2840-9-12
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study.1999 · 1,173 citations
  2. 2Flow-Mediated Vasodilation as a Diagnostic Modality for Vascular Failure2008 · 106 citations
  3. 3Estimation of the Concentration of Low-Density Lipoprotein Cholesterol in Plasma, Without Use of the Preparative Ultracentrifuge1972 · 32,626 citations
  4. 4Advantages of α-Glucosidase Inhibition as Monotherapy in Elderly Type 2 Diabetic Patients1998 · 129 citations
  5. 5Endothelial Function2005 · 1,096 citations