***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare the safety and efficacy of three doses of acarbose ( 100 , 200 , and 300 mg three times daily ) with placebo for the treatment of non-insulin-dependent diabetes mellitus ( NIDDM ) in patients maintained on dietary therapy alone . RESEARCH DESIGN AND METHODS This multicenter double-blind placebo-controlled trial was 22 weeks in duration . The trial consisted of a 2-week screening period , a 4-week placebo run-in period , and a 16-week double-blind treatment period . The primary measure of drug efficacy was the mean change from baseline in HbA1c levels . Additional efficacy variables included the mean change from baseline in fasting and postpr and ial plasma glucose and serum insulin levels . RESULTS After 16 weeks of treatment , acarbose-treated patients had statistically significant reductions in mean HbA1c levels of 0.78 , 0.73 , and 1.10 % ( relative to placebo ) in the 100- , 200- , and 300-mg t.i.d . groups , respectively . Significant reductions in fasting and postpr and ial plasma glucose levels , glucose area under the time-concentration curve , and maximum glucose concentration were also observed in acarbose-treated patients . Although there were no statistically significant differences among the 100- , 200- , and 300-mg treatment groups , there was a trend toward a dose-response relationship for most plasma glucose variables that were measured . Gastrointestinal side effects ( e.g. , abdominal pain , flatulence , and diarrhea ) and serum transaminase elevations ( e.g. , aspartate aminotransferase [ AST ] and alanine aminotransferase [ ALT ] were more frequently reported in the acarbose-treated patients than in the placebo-treated control patients . Transaminase elevations occurred only at the 200- , and 300-mg dosages and were readily reversible on discontinuation of treatment . CONCLUSIONS Acarbose at doses of 100 , 200 , and 300 mg administered three times daily for 16 weeks significantly reduced HbA1c levels and postpr and ial hyperglycemia . Treatment with acarbose is a safe and effective adjunct to dietary therapy for the treatment of NIDDM Summary The effect of acarbose , an alpha-glucosidase inhibitor , on glycaemic control , was compared with placebo in a double-blind , r and omised , group comparison study during 16 weeks in 20 non-obese non-insulin dependent diabetic patients in whom sulphonylurea treatment had been withdrawn . There was significant deterioration in glycaemic control as assessed by HbA1 following withdrawal of the sulphonylurea . There was no significant improvement in HbA1 between weeks 0 and 16 in either the acarbose ( 11.3 % and 12.4 % respectively ) or the placebo group ( 10.6 % and 12.2 % respectively ) . In both the acarbose and placebo treated groups fasting glucose and insulin concentrations were unaltered . This study also suggests that acarbose was not an effective substitute for sulphonylureas in non-obese Type 2 diabetes uncontrolled by diet alone CONTEXT The worldwide explosive increase in type 2 diabetes mellitus and its cardiovascular morbidity are becoming major health concerns . OBJECTIVE To evaluate the effect of decreasing postpr and ial hyperglycemia with acarbose , an alpha-glucosidase inhibitor , on the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance ( IGT ) . DESIGN , SETTING , AND PARTICIPANTS International , multicenter double-blind , placebo-controlled , r and omized trial , undertaken in hospitals in Canada , Germany , Austria , Norway , Denmark , Sweden , Finl and , Israel , and Spain from July 1998 through August 2001 . A total of 1429 patients with IGT were r and omized with 61 patients ( 4 % ) excluded because they did not have IGT or had no postr and omization data , leaving 1368 patients for a modified intent-to-treat analysis . Both men ( 49 % ) and women ( 51 % ) participated with a mean ( SD ) age of 54.5 ( 7.9 ) years and body mass index of 30.9 ( 4.2 ) . These patients were followed up for a mean ( SD ) of 3.3 ( 1.2 ) years . INTERVENTION Patients with IGT were r and omized to receive either placebo ( n = 715 ) or 100 mg of acarbose 3 times a day ( n = 714 ) . MAIN OUTCOME MEASURES The development of major cardiovascular events ( coronary heart disease , cardiovascular death , congestive heart failure , cerebrovascular event , and peripheral vascular disease ) and hypertension ( > or = 140/90 mm Hg ) . RESULTS Three hundred forty-one patients ( 24 % ) discontinued their participation prematurely , 211 in the acarbose-treated group and 130 in the placebo group ; these patients were also followed up for outcome parameters . Decreasing postpr and ial hyperglycemia with acarbose was associated with a 49 % relative risk reduction in the development of cardiovascular events ( hazard ratio [ HR ] , 0.51 ; 95 % confidence interval [ CI ] ; 0.28 - 0.95 ; P = .03 ) and a 2.5 % absolute risk reduction . Among cardiovascular events , the major reduction was in the risk of myocardial infa rct ion ( HR , 0.09 ; 95 % CI , 0.01 - 0.72 ; P = .02 ) . Acarbose was also associated with a 34 % relative risk reduction in the incidence of new cases of hypertension ( HR , 0.66 ; 95 % CI , 0.49 - 0.89 ; P = .006 ) and a 5.3 % absolute risk reduction . Even after adjusting for major risk factors , the reduction in the risk of cardiovascular events ( HR , 0.47 ; 95 % CI , 0.24 - 0.90 ; P = .02 ) and hypertension ( HR , 0.62 ; 95 % CI , 0.45 - 0.86 ; P = .004 ) associated with acarbose treatment was still statistically significant . CONCLUSION This study suggests that treating IGT patients with acarbose is associated with a significant reduction in the risk of cardiovascular disease and hypertension BACKGROUND Acarbose is an oral antidiabetic mainly acting on postpr and ial blood glucose , inhibiting alphaglucosidase . Through this mechanism , it could improve the peripheral insulin sensitivity and /or increase the insulin secretion . The aim of the present study is to assess the therapeutic efficacy of Acarbose in obese type 2 diabetic patients on both insulin resistance and insulin secretion . METHODS 17 obese non insulin-dependent diabetic patients , well controlled with diet alone were r and omized into 2 groups : acarbose ( 2 x 50 mg ) or placebo during 16 weeks . A glucagon test allowed to evaluate insulin secretion before and after treatment as well as a triple test ( glucose-insulin-somatostatin ) with indirect calorimetry allowed to evaluate insulin sensitivity . RESULTS A significant improvement in post-pr and ial plasma glucose was detected only in the Acarbose group ( 8.0 + /- 0.5 mmol/l before vs 6.5 0.5 mmol/l after , p<0.05 ) . Basal C-peptide secretion was similar between groups and remained unchanged after treatment . However , stimulated insulin secretion was significantly increased by 30 % , p<0.05 , in the Acarbose group while no change was detected in the placebo group . Interestingly , the group receiving Acarbose disclosed a 15 % reduction in insulin resistance ( 15.0 + /- 1.8 mmol/l before vs 12.8 + /- 1.4 mmol/l after ) . CONCLUSIONS Our results show that a treatment with Acarbose is efficient even in diabetic patients presenting a good glucose control without any other associated treatment . By decreasing post-pr and ial blood glucose , acarbose improves both insulin sensitivity and secretion Water-extracted Touchi , a traditional Chinese food , exerts a strong inhibitory activity against rat intestinal alpha-glucosidase in foodstuffs , and Touchi-extract ( TE ) has been shown to have an antihyperglycemic effect in rats and humans after a single oral administration . In the present complementary study , the effects of powdered Houji-tea with or without ( placebo ) TE , a formula design ed to enhance good compliance , were monitored in a 3-mo double-blind r and omized group comparison study with placebo controls in humans with borderline and mild type-2 diabetes ( n = 36 ) . All subjects ingested Houji-tea with or without 0.3 g of TE before each of three meals per day for 3 mo . In the TE group , initial fasting blood glucose ( 6.9 + /- 0.1 mmol/L ) and glycated hemoglobin ( HbA(1c ) ; 6.1 + /- 0.1 % ) levels gradually decreased ; fasting blood glucose decreased significantly after 3 mo ( 6.4 + /- 0.3 mmol/L ; P < 0.05 ) as did HbA(1c ) ( 5.6 + /- 0.2 % ; P < 0.01 ) levels at 2 mo postingestion of TE and thereafter . In contrast , fasting blood glucose and HbA(1c ) levels did not change in the placebo group . In this study , other biochemical variables were not affected in any of the subjects , and no one complained of any side effects or abdominal distension . Moreover , there was no deterioration as assessed by fasting blood glucose and HbA(1c ) levels after withdrawal of TE ingestion . Thus , the alpha-glucosidase inhibitory TE demonstrated an antihyperglycemic effect and may prove useful for improving glycemic control in subjects suffering from borderline and type-2 diabetes mellitus The efficacy of the new intestinal alpha-glucosidase inhibitor , miglitol , and glibenclamide were compared in a 6-month double-blind controlled protocol involving 100 non-insulin dependent diabetic patients under diet alone .  HbA1c levels ( initially between 7 and 11 % ) were reduced ( p < 0.05 ) : -0.78 + /- 0.21 % after miglitol and -1.18 + /- 0.20 % after glibenclamide . The difference between the two treatments was not significant , although glibenclamide appeared to be more active than miglitol at 8 ( p = 0.002 ) and 16 weeks ( p = 0.01 ) but not at 24 weeks . Fasting glycaemia decreased after miglitol ( 8.7 + /- 0.3 vs 9.6 + /- 0.3 mmol/l , p = 0.005 ) and after glibenclamide ( 8.0 + /- 0.3 vs 9.1 + /- 0.3 , p = 0.007 ) . After miglitol , a decrease was noted after breakfast ( p < 0.001 ) and lunch ( p < 0.001 ) . The same was true for glibenclamide ( p = 0.004 and p < 0.001 respectively ) . A significant reduction in glucose incremental area during a st and ard meal test was noted at the end of miglitol ( p = 0.008 ) or glibenclamide treatment ( p = 0.04 ) . Subgroups of nonresponders to both treatments were identified ( 10/49 with miglitol , 9/47 with glibenclamide ) . Side effects were recorded in 10 patients treated with miglitol ( flatulence and meteorism , diarrhoea , 1 discontinued therapy ) and in 10 treated with glibenclamide  ( asthenia , sensation of hunger ) . This study indicates that miglitol is suitable for initial application in diet-resistant Type 2 diabetic patients , providing , a persistent effect and acceptable side effects OBJECTIVE To study the effect of acarbose , an alpha-glucosidase inhibitor , on insulin release and insulin sensitivity in elderly patients with type 2 diabetes . RESEARCH DESIGN AND METHODS Elderly patients with type 2 diabetes were r and omly treated in a double-blind fashion with  placebo ( n = 23 ) or  acarbose ( n = 22 ) for 12 months . Before and after r and omization , subjects underwent a meal tolerance test and a hyperglycemic glucose clamp study design ed to measure insulin release and sensitivity . RESULTS After 12 months of therapy there was a significant difference in the change in fasting plasma glucose levels ( 0.2 + /- 0.3 vs. -0.5 + /- 0.2 mmol/l , placebo vs. acarbose group , respectively ; P < 0.05 ) and in incremental postpr and ial glucose values ( -0.4 + /- 0.6 vs. -3.5 + 
    Output:
    
We found a decreasing effect on post-load insulin and no clinical ly relevant effects on lipids or body weight .
Adverse effects were mostly of gastro-intestinal origin and dose dependent .
AUTHORS ' CONCLUSIONS It remains unclear whether alpha-glucosidase inhibitors influence mortality or morbidity in patients with type 2 diabetes .
Conversely , they have a significant effect on glycemic control and insulin levels , but no statistically significant effect on lipids and body weight .
These effects are less sure when alpha-glucosidase inhibitors are used for a longer duration .
Acarbose dosages higher than 50 mg TID offer no additional effect on glycated hemoglobin but more adverse effects instead .
Compared to sulphonylurea , alpha-glucosidase inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects