Characteristics of type 2 diabetic patients responding to voglibose administration as an adjunct to sulfonylurea

In this study, we characterized type 2 diabetic patients responding well to the alpha -glucosidase inhibitor voglibose administration as an adjunct to sulfonylurea treatment. Thirty-three type 2 diabetic patients were enrolled in an open prospective study. All the patients had been treated for at least I year with a sulfonylurea drug, in whom HbAlc level had been stable for at least 12 weeks. The patients were given voglibose at a dose of 0.2 mg t.i.d. for 12 weeks. Voglibose administration significantly decreased the mean HbAlc level in all the patients at 4, 8, and 12 weeks. Twelve (36%) of the study patients were responders, when the responders were defined as patients whose HbAlc level at 12 weeks fell by at least 1.0% from baseline, or those whose HbAlc level at 12 weeks was less than or equal to 7.0%, falling by at least 0.5% from baseline. The baseline fasting plasma glucose (FPG) was significantly lower, and the baseline homeostasis model assessment (HOMA) beta -cell function (HOMA-%beta) was significantly higher in the responders than in the non-responders. There were more patients who had FPG < 170 mg/dl and/or HOMA-%beta greater than or equal to 30% in the responders than in the non-responders (P < 0.005). None of the patients with both FPG greater than or equal to 170 mg/dl and HOMA-%beta > 30% responded to the adjunct treatment. These results indicate that baseline FPG and HOMA-%beta are useful clinical markers to predict the effectiveness of the adjunct therapy of voglibose in sulfonylurea-treated type 2 diabetic patients. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.