The effects of nateglinide versus acarbose on postprandial serum free fatty acid levels in patients with type 2 diabetes

Objective To investigate the effects of nateglinide versus acarbose on postprandial serum free fatty acids (FFA) and triglyceride (TG) levels in patients with newly diagnosed type 2 diabetes. Methods A crossover trial of nateglinide (120mg tid for 4 weeks) and acarbose (50 mg tid for another 4 weeks) treatment was conducted on 16 drug-naive patients with newly diagnosed type 2 diabetes during a total period of 9 weeks.In order to assess the acute effects of nateglinide or acarbose on postpradial glucose,insulin,FFA and TG levels,a standard meal was consumed with the first dose of medication on the first day of each treatment arm.Blood samples were collected from both arms at 0,30,60,and 120 min after the standard meal test.Plasma glucose,serum insulin,FFA and TG were measured.Results A single dose of nateglinide and acarbose showed similar efficiencies for lowering postprandial hyperglycemia.Compared with acarbose,nateglinide significantly increased postprandial 30-min insulin secretion and decreased postprandial 120-min FFA levels after a standard meal test in the patients with type 2 diabetes.Postprandial TG levels were not significantly different between nateglinide and acarbose treatment.The fasting levels of serum FFA and TG were unchanged after 4 weeks of treatment with either nateglinide or acarbose.Conclusions Nateglinide has an advantage in the reduction of postprandial FFA levels in comparison with acarbose,which may be associated with the partial restoration of early phase insulin secretion resulted from nateglinide.