식이요법으로 잘 조절되지 않는 인슐린 비의존형 당뇨병 환자에서 Acarbose의 치료 효과

/A Backgroud: Acarbose is an alpha-glucosidase inhibitor which reversibly and competitively inhibits the digestion of oligo-and disaccharides at the brush border of the small intestine. We tried to determine 1) the efficacy of Acarbose treatment in terms of diabetes control, 2) its effect on insulin secretion after oral glucose load, and 3) possible side effects. Methods: Twenty NIDDM patients insufficiently treated diet alone were included in the trial. Acarbose was given at the dosage of 100 mg before each meal. Fasting and postprandial blood glucose were measured in every 4 weeks, Glycated hemoglobin and lipid profiles were followed up in every 8 weeks. Insulin responses after oral glucose load were repeated before and after Acarbose triai. Results: Acarbose reduced fasting blood glucose by 13.4%, postprandial glucose by 26.0% and glycated hemoglobin by 14.0%. Total and HDL-cholesterol levels were not changed but serum triglyceride was reduced by 17.6%. There was a tendency of decrement in insulin response after oral glucose load. Gastrointestinal discomforts were developed in 8(40%) patients but those were mild and tolerable. Conclusion: Acarbose is an efficient and acceptable drug for the treatment of NIDDM with poor metabolic control by diet alone.