AUGMENTING GLIMEPIRIDE THERAPY WITH VOGLIBOSE OR ACARBOSE: IMPLICATIONS FOR TYPE 2 DIABETES MANAGEMENT

Main Article Content

Masuram Bharath Kumar
Shalini Chandra
KV Thimmaraju

Keywords

Type 2 Diabetes Mellitus, Voglibose, Acarbose, Postprandial Blood Sugar, Medication Adherence

Abstract

Background: Managing Type 2 Diabetes Mellitus (T2DM) often necessitates a multi-drug approach for adequate glycemic control. This study aimed to compare the efficacy and tolerability of voglibose and acarbose as adjunctive therapies to glimepiride in T2DM patients.


 Methods: A prospective, open-label, non-randomized, parallel-group study was conducted over six months, involving 64 adult T2DM patients already on a stable dose of glimepiride. Patients were divided into two groups: Group I received voglibose, and Group II received acarbose as an add-on therapy. Primary outcome measures included changes in Hemoglobin A1c (HbA1c), Fasting Blood Sugar (FBS), and Postprandial Blood Sugar (PPBS). Medication adherence was evaluated using the Morisky Medication Adherence Scale.


 Results: Both groups significantly reduced HbA1c, FBS, and PPBS. The voglibose group exhibited a more pronounced reduction in HbA1c levels at six months, with a p-value of 0.00001. There was no significant difference between the two groups in FBS, PPBS, or medication adherence.


 Conclusion: Both voglibose and acarbose were effective add-on therapies to glimepiride in improving glycemic control in T2DM patients. However, voglibose showed a slight edge in reducing HbA1c levels. These findings can serve as a basis for future large-scale, randomized studies to validate the comparative efficacy of these two medications

Abstract 84 | pdf Downloads 52

References

1. World Health Organization. Global report on diabetes. WHO, 2016.
2. Kahn SE, Cooper ME, Del Prato S. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet. 2014;383(9922):1068-1083.
3. American Diabetes Association. Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(Supplement 1):S1-S232.
4. Al-Saleh Y, Sabico S, Al-Furqani A, Jayyousi A, Alromaihi D, Ba-Essa E, Alawadi F, Alkaabi J, Hassanein M, Al-Sifri S, Saleh S, Alessa T, Al-Daghri NM. Sulfonylureas in the Current Practice of Type 2 Diabetes Management: Are They All the Same? Consensus from the Gulf Cooperation Council (GCC) Countries Advisory Board on Sulfonylureas. Diabetes Ther. 2021 Aug;12(8):2115-2132
5. Turner RC, Cull CA, Frighi V, Holman RR. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). JAMA. 1999;281(21):2005-2012.
6. van de Laar FA, Lucassen PL, Akkermans RP, van de Lisdonk EH, Rutten GE, van Weel C. Alpha-glucosidase inhibitors for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005;(2):CD003639.
7. Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359(15):1577-1589.
8. Vichayanrat A, Ploybutr S, Tunlakit M, Watanakejorn P. Efficacy and safety of voglibose in comparison with acarbose in type 2 diabetic patients. Diabetes Res Clin Pract. 2002 Feb;55(2):99-103. doi: 10.1016/s0168-8227(01)00286-8. PMID: 11796175.
9. Rosak C, Mertes G. Critical evaluation of the role of acarbose in the treatment of diabetes: patient considerations. Diabetes Metab Syndr Obes. 2012;5:357-367.
10. Chowdhury TA, Grant P. Drug therapies in type 2 diabetes: an era of personalised medicine. Clin Med. 2016 Oct;16(5):441-447.
11. Hong Y, Liu L, Su S, Xu Y, Wan Q, Yang X, Tang Y, Sun HY. The Efficacy and Safety of Acarbose compared with Voglibose in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. [Internet]. 2016 [cited 2021 Oct 20].
12. Hitoshi S, Mototsugu N, Taro H, Yasushi N, Kyoko T-I, Fumitaka O, Hideki T, Takeshi I, Takatoshi O, Masanobu K, Shinichi O. Comparison of three α-glucosidase inhibitors for glycemic control and bodyweight reduction in Japanese patients with obese type 2 diabetes. J Diabetes Investig. 2014;5(2):206-212.
13. Praful A, Talaviya B, Hardik GD, Shaival KR, Shashank RJ, Vipul BM, Sneha VG. Retrospective comparison of voglibose or acarbose as an add-on therapy to sulfonylureas in Western Indian patients with uncontrolled overweight/obese type 2 diabetes. Diabetes Metab Syndr Clin Res Rev. 2016;10(2):88-91.
14. Hitoshi S, Mototsugu N, Taro H, Yasushi N, Kyoko T-I, Fumitaka O, Hideki T, Takeshi I, Takatoshi O, Masanobu K, Shinichi O. Comparison of three α-glucosidase inhibitors for glycemic control and bodyweight reduction in Japanese patients with obese type 2 diabetes. J Diabetes Investig. 2014;5(2):206-212.
15. Teli Shaikh ES, Sarang Anantrao D. Comparative study of effect of alpha glucosidase inhibitors – Miglitol, Acarbose and Voglibose on postprandial hyperglycemia and glycosylated hemoglobin in type-2 diabetes mellitus. Int J Pharm Bio Sci. 2012;3(3):337-343.
16. Vichayanrat A, Ploybutr S, Monchaya T, Praneet W. Efficacy and safety of voglibose in comparison with acarbose in type 2 diabetic patients. Diabetes Res Clin Pract. 2002;55(2):99-103.
17. Hanefeld M. Cardiovascular benefits and safety profile of acarbose therapy in prediabetes and established type 2 diabetes. Cardiovasc Diabetol. 2007;6:20

Most read articles by the same author(s)