{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:29:03Z","timestamp":1759177743238},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,9,20]],"date-time":"2013-09-20T00:00:00Z","timestamp":1379635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The anti\u2010diabetic agent acarbose reduces postprandial glucose excursions. We have evaluated the effect of randomized treatment with acarbose on the progression of carotid intima\u2013media thickness (IMT) in early diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Early Diabetes Intervention Program was a randomized trial of acarbose <jats:italic>versus<\/jats:italic> placebo in 219 participants with early diabetes characterized by glucose values over 11.1\u2009mmol\/L 2\u2009h after a 75\u2009g oral glucose load and a mean HbA<jats:sub>1c<\/jats:sub> of 6.3%. IMT was measured at baseline and yearly. Follow\u2010up was discontinued if participants progressed to the study glucose endpoints; IMT readings were available for a median of 2\u2009years, with 72 subjects followed for 5\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Progressive increases in IMT were seen in both treatment groups, but progression was reduced in participants randomized to acarbose (<jats:italic>p<\/jats:italic>\u2009=\u20090.047). In age, sex and smoking\u2010adjusted analyses, IMT progression was associated with greater fasting and oral glucose tolerance test\u2010excursion glucose, fasting insulin, cholesterol and glycated low\u2010density lipoprotein concentrations. IMT progression was reduced with study\u2010related changes in weight, insulin and non\u2010esterified fatty acids; these features were more strongly associated with reduced IMT progression than acarbose treatment. Despite strong associations of baseline glycemia with IMT progression, study\u2010related changes in glucose were not important determinants of IMT progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Acarbose can delay progression of carotid intima\u2013media thickness in early diabetes defined by an oral glucose tolerance test. Glucose, weight, insulin and lipids contributed to risk of progression but reductions in glycemia were not major determinants of reduced rate of IMT progression. Vascular benefits of acarbose may be independent of its glycemic effects. 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