Preliminary data support oral acarbose as insulin alternative. (Gestational Diabetes).

LOS ANGELES -- Oral acarbose may be as effective as insulin therapy for glycemic control in patients with gestational diabetes if they adhere to dietary recommendations, a preliminary study of 110 patients suggests.

A larger multicenter trial is underway to corroborate the efficacy and safety of acarbose (Precose) as an alternative to insulin in these patients. Results of that trial will be needed before acarbose can be recommended for widespread use in patients with gestational diabetes, Dr. Margarita de Veciana said at the annual meeting of the American College of Obstetricians and Gynecologists.

All participants in the current study received diabetes education and dietary counseling. The women were asked to eat 1,8002,000 calories/day in three meals and three snacks; 40%-45% of their calories came from carbohydrates.

Diet alone does not achieve euglycemia in 10%-20% of women with gestational diabetes. AGOG recommends insulin therapy when dietary changes are insufficient.

The women in the study had failed to reach glycemic control using diet alone and were randomized to further therapy with acarbose or insulin, said Dr. de Veciana, director of the diabetes in pregnancy program and perinatal research at Eastern Virginia Medical School, Noffolk.

The 56 patients in the acarbose group started out taking 25 mg of the agent three ...