[Short term assessment of anthropometric indices and metabolic parameters in obese subjects treated with acarbose]

Acarbose represents the first of a new class of oral antidiabetic drugs: the alpha-glucosidases inhibitors. This drug in fact delays the production of monosacchtarides inhibiting the alpha-glucosidases of the small bowel, that are responsible of digestion of complex polysaccharides and sucrose. In patients with insulin dependent diabetes mellitus (IDDM) acarbose, significantly reduces the postprandial blood glucose levels, and improves the symptoms associated with nocturnal hypoglycaemia reducing the daily insulin dosage. Furthermore acarbose ameliorates the glycemic control of obese patients when associated with hypocaloric diet. The aim of our study has been to value the effectiveness of acarbose 300 mg/day for 12 weeks in patients affected by moderate obesity (30 < - BMI < 40) and with impaired glucose tolerance (IGT). We have studied 12 patients, 6 have been treated with acarbose and hypocaloric diet, while the other 6 have been treated only with diet, these last formed the control group. Before and after the treatment, anthropometric indexes and haematologic parameters have been observed. Patients treated with acarbose presented a significative decrement of body weight, BMI, fat free mass, fat mass and of basal and peak glycaemic values after oral glucose tolerance test (OGTT). Serum lipid values, insulin levels during OGTT and blood pressure presented a not significative improvement. Gastrointestinal symptoms such as flatulence and borborygmus have been reported only in the patients treated with acarbose. The incidence of these reactions usually decreases with time.