"Low Dose" Metformin Improves Hyperglycemia Better Than Acarbose in Type 2 Diabetics

Original Data

Rev Diabet Stud, 2004, 1(2):89-94

DOI 10.1900/RDS.2004.1.89

"Low Dose" Metformin Improves Hyperglycemia Better Than Acarbose in Type 2 Diabetics

Ken Yajima¹^,², Akira Shimada¹, Hiroshi Hirose¹, Akira Kasuga³, Takao Saruta¹

¹Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
²Department of Internal Medicine, Hamamatsu Red Cross Hospital, Hamamatsu, 430-0907, Japan.
³Department of Internal Medicine, Tokyo Denryoku Hospital, Tokyo, 160-0016, Japan.
Address correspondence to: Akira Shimada, e-mail: asmd@st.itc.keio.ac.jp

Keywords: metformin, acarbose, type 2 diabetes, cross-over trial

Abstract

OBJECTIVES: "High dose" metformin therapy (2,550 mg/day) is reported to improve glycemic control in type 2 diabetic patients with obesity (body mass index (BMI) ≥ 30). Some have reported that metformin therapy, even in low doses (500-750 mg/day), improves glycemic control in non-obese type 2 diabetic patients (BMI approximately 25). However, it is unclear whether "low dose" metformin improves glycemic control better than acarbose in non-obese type 2 diabetic patients, which has been shown to improve glycemic control in type 2 diabetes with obesity. METHODS: We randomly divided 22 non-obese type 2 diabetic patients (mean BMI approximately 25) into two groups (A = 11, B = 11). Group A was treated with "low dose" metformin (500-750 mg/day) for 3 months, and switched to acarbose (150-300 mg/day) for another 3 months. Group B was treated with acarbose first, and then switched to "low dose" metformin. RESULTS: "Low dose" metformin significantly decreased the fasting plasma glucose (FPG) and HbA1c level in both groups A and B, whereas acarbose decreased HbA1c levels in group B but not in group A. Overall, "low dose" metformin significantly decreased HbA1c (p=0.0165) levels as compared to acarbose. CONCLUSION: In conclusion, "low dose" metformin therapy improved glycemic control better than acarbose in non-obese diabetics.

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