Exercise and Acarbose Improve Metabolic Control

Not only is diabetes a risk factor for cardiovascular disease, but evidence is growing that impaired fasting glucose is a risk as well. New research suggests that a combination of exercise training and acarbose (Precose, Bayer) can improve insulin sensitivity and may also reduce cardiovascular risk factors in people with mild type 2 diabetes.

Henrik Wagner, MD, and colleagues at Karolinska Institute in Stockholm, Sweden, studied the effect of acarbose and exercise training on glycemic control and insulin sensitivity in 62 men and women with type 2 diabetes. Participants were randomized to 12 weeks of structured exercise training with or without acarbose.

Exercise alone improved insulin sensitivity, decreased body fat, and reduced systolic blood pressure, but had no effect on oxygen uptake or glycated hemoglobin (A1C). Acarbose alone had no effect on insulin sensitivity or A1C levels, but lowered systolic and diastolic blood pressure as well as fasting proinsulin levels.

The combination of exercise and acarbose decreased fasting plasma glucose, A1C, lipids, diastolic blood pressure, and oxygen uptake. This combination is "associated with significant improvement in glycemic control and possibly cardiovascular risk factors," researchers conclude.