Together with lifestyle changes, the drug Voglibose reduces the progress of type 2 diabetes in high-risk Japanese people. Professor Ryuzo Kawamori, from the Juntendo University School of Medicine, in Tokyo, Japan, and his colleagues report their findings in an article published Online First and in a future edition of The Lancet.

Voglibose, a α-glucosidase inhibitor, lowers the amount of glucose absorbed into the bloodstream. The randomized trial included 1,780 eligible participants that showed signs of impaired glucose tolerance, but not full-blown diabetes. 897 were assigned daily three oral doses of 0.2mg of voglibose, and the remaining 883 received a placebo. All participants maintained a regular diet and performed routine exercise. Treatment was continuous for a minimum of three years or until participants developed either type 2 diabetes or normal blood sugar control (normoglycaemia).

The study shows that after one year of treatment, participants consuming voglibose had more effective results than those on the placebo, having a 40 percent lower risk of developing type 2 diabetes and 54 percent more likely to reach normoglycaemia. Probably associated with the treatment, there were adverse effects on 48 percent of the participants with voglibose compared to only 29 percent in the placebo group. However, in both groups there were reports of some serious adverse events. In the voglibose group, there was a gall bladder inflammation, a colonic polyp, a rectal tumor, an inguinal hernia, a liver dysfunction and a brain hemorrhage. In the placebo group there was a report of a blockage of brain blood-flow and a swelling of a gall-bladder.

The authors write in conclusion: “Voglibose significantly improved glucose tolerance, in terms of delayed disease progression and in the number of patients who achieved normoglycaemia. Thus, long-term prophylaxis with this α-glucosidase inhibitor in high-risk individuals with impaired glucose tolerance could provide a pharmacological option, along with lifestyle modification, to help reduce the burden of type 2 diabetes in Japan.”

In a supplementary note, Dr André J Scheen, Division of Diabetes, Department of Medicine, University of Liège, Belgium, remarks: “[This] study showed that, if best efforts to educate individuals do not work, treatment with voglibose could be an important way forward.” He also suggests that the same results could be obtained for other populations since they match documented results of comparable trials in Europe and Canada.

Written by Stephanie Brunner (B.A.)