Q2. How many participants were required to provide appropriate lifestyle advice during the run-in period?
During the run-in period 7 investigators were required to provide all participants with appropriate lifestyle advice with respect 8 to diet, exercise and smoking.
Q3. how long does acarbose help prevent diabetes in high-risk populations?
The reduced 19 incidence of diabetes seen with acarbose in the ACE trial may, however, help reduce 20 cardiovascular risk in the longer term by delaying the onset of diabetes in the high-risk population 21 studied.
Q4. how much did acarbose reduce the incidence of type 2 diabetes in china?
In 2006, the prevalence of impaired 3 glucose regulation in Chinese adults hospitalised for coronary artery disease was 37·3%.5 4 After the Study to Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) reported that 5 acarbose, an alpha-glucosidase inhibitor, reduced the incidence of type 2 diabetes by 25% in people 6 with impaired glucose tolerance,6 it was approved for treating this condition in China and elsewhere.
Q5. What is the role of acarbose in the prevention of type 2 diabetes?
Acarbose has also been shown to slow progression of 10 carotid artery intima-media thickness in people with impaired glucose tolerance.8
Q6. What is the effect of acarbose on the risk of new-onset?
26 26 In Chinese patients with impaired glucose tolerance and coronary heart disease, acarbose did not 27 reduce the risk of major cardiovascular events but did reduce the risk of new-onset diabetes.
Q7. how much acarbose can reduce the risk of cardiovascular events?
24 12 The 18% statistically significant lower risk of incident diabetes seen in the ACE trial high risk 13 cardiovascular population was less than the 25% reduction observed over mean 3·3 years in the 14 STOP-NIDDM low cardiovascular risk population (4·8% with a prior cardiovascular event).
Q8. What was the effect of acarbose on the kidney?
14 Acarbose was reported to reduce cardiovascular events in a secondary analysis of the STOP-15 NIDDM trial,7 but with only 47 participants having the outcome in question this could be a chance 16 finding.
Q9. What other outcomes were reported as post hoc secondary endpoints?
To avoid confounding by competing mortality risks, the authors have chosen to report fatal or nonfatal 13 myocardial infarction and fatal or nonfatal stroke as post hoc secondary endpoints, rather than 14 nonfatal myocardial infarction and nonfatal stroke.
Q10. What was the hazard ratio and 95% confidence interval?
A Cox regression model with 12 treatment arm as a predictor was used to derive the hazard ratio and 95% confidence interval (CI).
Q11. How many sites were used to conduct the study?
This randomised, double-blind, placebo-controlled, event-driven, Phase IV superiority trial was 21 conducted at 176 sites in China.
Q12. What is the impact of the NAVIGATOR study on the cardiovascular risk of diabetes?
On the basis of the data from this trial and the NAVIGATOR study it would appear that, despite the 16 strong epidemiological data linking postprandial hyperglycaemia to increased cardiovascular risk, 17 directly targeting postprandial hyperglycaemia does not directly reduce the risk of cardiovascular 18 events in populations at high cardiovascular risk and with impaired glucose tolerance.