Possibilities of preventing type 2 diabetes in patients with early carbohydrate metabolic disturbances

Abstract

An open comparative randomized study of the efficacy of metformin and acarbose was conducted in patients with glucose metabolic abnormalities (GMA). Croup 1 (n = 20) received metformin in a daily dose of 1700 mg along with the standard recommendations for lifestyle modification; Croup 2 (n = 16) took acarbose in a daily dose of 150 mg; Group 3 (n = 13) was control and followed only the standard recommendations for lifestyle modification. The purpose of the study was to estimate the influence of metformin and acarbose therapy in combination with lifestyle modification on the development of type 2 diabetes mellitus (DM2) in persons with early GMA, by applying a mathematical analysis of the results of the intravenous glucose tolerance test (determination of the rates of blood glucose elimination (k-index) and hepatic glucose pro-duction (It-Index). Unlike acarbose-treated and control persons, metformin-treated patients with early GMA showed a reduced insulin resistance (IR-HO-MA-2 by 29%) and lower hepatic glucose hyperproduction (It-index by 25%). Six-month use of metformin resulted in normalization of carbohydrate metabolism by 33.3% of the patients having GMA at baseline, GMA transition to DM2 being noted in 26.7%. The administration of acarose favored normalization of carbohydrate metabolism in 40% of cases, GMA transition to DM2 being seen in 20%. In the controls, there were no cases of normalized carbohydrate metabolism and GMA transition to DM2 occurring in 40%.