Assessing the potential for α-glucosidase inhibitors in prediabetic states
Abstract
Type 2 diabetes often has an insidious onset with hyperglycaemia being present for many years before diagnosis is made. It is a progressive disease, due in part to loss of beta-cell function, with the reduction in function probably commencing 10-12 years prior to diagnosis and being aggravated by increasing fasting plasma glucose levels. Earlier intervention in those at risk from type 2 diabetes, aimed at minimizing hyperglycaemia, may prevent or delay overt diabetes and the associated development of micro- and macrovascular disease. Six-year follow-up data from the UK Prospective Diabetes Study, confirm that sulphonylurea, metformin and insulin therapy can reduce hyperglycaemia in individuals with type 2 diabetes. Although none of these agents prevent the subsequent progressive increase in fasting glucose levels, preliminary results with acarbose show that fasting plasma glucose levels can be maintained over 1 year of therapy. Three large-scale studies are currently investigating whether treatment with acarbose at an earlier stage of the disease process, in subjects with varying degrees of glucose intolerance, may be beneficial in helping to prevent or delay the onset of diabetes.
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In the UKPDS cohort of subjects with recently diagnosed Type 2 diabetes, there is an ongoing decline in beta-cell function without a change in insulin sensitivity.
“in this cohort of subjects with recently diagnosed Type 2 diabetes, an ongoing decline in beta-cell function without a change in insulin sensitivity was occurring [17, 18].”
From The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes (2003) · cites this paper as [18]
Data from the UKPDS suggest that beta-cell dysfunction commences years before hyperglycaemia develops.
“Data from the UKPDS strongly suggest that beta-cell dysfunction commences years before hyperglycaemia develops [18].”
From The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes (2003) · cites this paper as [18]
Based on the UKPDS and the longitudinal assessment in Pima Indians, the major reason for the decline in glucose tolerance seems to be a progressive loss of beta-cell function.
“Based on the UKPDS [18] and the longitudinal assessment in Pima Indians [95], the major reason for the decline in glucose tolerance seems to be a progressive loss of beta-cell function.”
From The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes (2003) · cites this paper as [18]
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- Authors
- Holman, R. R.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- Holman, Rury R
- ORCID
- Holman, Rury R
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 1998-07
- Volume
- 40
- Pages
- S21-S25
- ISSN
- 0168-8227 (ISSN-L)
- OpenAlex
- W2084644316
- Cited by
- 197
- References
- 24
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 9 · 2023: 3 · 2022: 3 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 3 · 2017: 12 · 2016: 9 · 2015: 8 · 2014: 18 · 2013: 6 · 2012: 11
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Research and Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- alpha-glucosidase inhibitors, acarbose, prediabetes, type 2 diabetes prevention, impaired glucose tolerance, hyperglycemia, beta-cell function, UK Prospective Diabetes Study, sulfonylureas, metformin, insulin therapy
- MeSH terms
- Diabetes Mellitus, Type 2, Enzyme Inhibitors, Glucosidases, Humans, Hypoglycemic Agents, Prediabetic State, Trisaccharides, Randomized Controlled Trials as Topic, Acarbose
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