Effects of acarbose in patients with beta-thalassaemia major and abnormal glucose homeostasis.

Seventeen TM patients with impaired glucose tolerance (IGT) or non-insulin dependent diabetes mellitus (NIDDM) and hyperinsulinism were treated for 12 months with acarbose (100 mg. orally with breakfast, lunch and evening meals). An improvement in glucose tolerance was observed in 2 out of 11 TM patients with IGT and in all TM patients with NIDDM. Acarbose does not appear to directly improve insulin resistance but may have an indirect effect delaying the absorption of glucose of complex carbohydrates and disaccharides. It may be concluded that acarbose may represent a useful first-line therapy for improving glycemic control in TM patients with abnormalities of glucose homeostasis and hyperinsulinism.