Cardiovascular benefits and safety profile of acarbose therapy in prediabetes and established type 2 diabetes

Researchers reviewed controlled trials of acarbose in adults with prediabetes, meaning blood sugar was above normal but not yet in the diabetes range, and type 2 diabetes, a disease causing high blood sugar. One major study included 1,429 people with prediabetes, and seven diabetes trials included about 2,180 people. Acarbose, a pill that slows the digestion of carbohydrates and reduces after-meal blood sugar rises, was compared with a placebo, an inactive dummy pill. Some analyses found fewer heart and blood-vessel problems and heart attacks with acarbose, but stomach problems such as gas and diarrhea were common, and the heart findings were not the main outcome in most studies.

What this means for you: This evidence is not strong enough to use acarbose mainly for heart protection. It may help control blood sugar, but its heart benefits remain uncertain and its stomach side effects can be bothersome.