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Review: glucosidase inhibitors improve glycaemic control but have uncertain effects on patient-important outcomes in type 2 diabetes

Q In patients with type 2 diabetes mellitus, are glucosidase inhibitors effective for improving glycaemic control?

Clinical impact ratings GP/FP/Primary care IM/Ambulatory care Endocrine

Key Words: diabetes mellitus (type 2) • glucosamine • hypoglycaemic agents • iInositol • alpha glucosidases

The first 150 words of the full text of this article appear below.

METHODS
Data sources: Medline (to April 2003), EMBASE/Excerpta Medica (to April 2003), the Cochrane Central Register of Controlled Trials (Issue 3, 2003), LILACS (to April 2003), databases of ongoing trials (all to April 2003), Current Contents (to December 2003), contacting experts and manufacturers, and bibliographies of relevant studies.

Study selection and assessment: randomised controlled trials (RCTs) in any language with 12 weeks’ duration that compared glucosidase inhibitor monotherapy with any other intervention in patients with type 2 diabetes and included 1 predefined clinical outcome. Study quality assessment included randomisation, allocation concealment, blinding, and attrition.

Outcomes: glycaemic control, lipid concentrations, body weight, adverse effects, mortality, diabetes related morbidity, and quality of life.

MAIN RESULTS
41 RCTs (n = 8130) were included. Most studies were 24 weeks in duration. -glucosidase inhibitors improved glycated haemoglobin and fasting blood glucose concentrations (table). Lipid concentrations and body weight were not affected. Acarbose was associated with a greater . . . [Full text of this article]

William L Isley, MD

Mayo Clinic
Rochester, Minnesota, USA