eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 15
Clinical research

MARCH: factors associated with weight loss in patients with newly diagnosed type 2 diabetes treated with acarbose or metformin

Na Wang, Jin-Ping Zhang, Xiao-Yan Xing, Zhao-Jun Yang, Bo Zhang, Xin Wang, Wen-Ying Yang

Arch Med Sci 2019; 15, 2: 309–320
Online publish date: 2018/04/20
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
In this secondary analysis of the Metformin and AcaRbose in Chinese as the initial Hypoglycaemic treatment (MARCH) trial, we evaluated what demographic and clinical factors were associated with reduction in weight. We also assessed the effects of acarbose and metformin treatment on weight reduction.

Material and methods
We analyzed the demographic and clinical laboratory values from the 784 patients with type 2 diabetes of the MARCH study who were treated for 48 weeks with acarbose or metformin. We determined the association of the different parameters with a weight reduction of ≥ 2 kg in patients using univariate and multivariate analysis.

In patients treated with acarbose, males were less likely than females to lose ≥ 2 kg of weight (p = 0.025). Higher baseline HbA1c levels and lower decreases from baseline in fasting plasma glucose (FPG) levels after 48 weeks of treatment were negatively associated with losing ≥ 2 kg of weight (both, p < 0.05). Higher baseline glucagon AUC was also positively associated with reducing weight by ≥ 2 kg (p = 0.010). In patients treated with metformin, change from baseline in whole body insulin sensitivity increased the odds of having a weight reduction of ≥ 2 kg (p = 0.014).

This study found that for both acarbose and metformin, control of FPG significantly impacted weight loss. Baseline AUC for glucagon in patients treated with acarbose and an increase of whole body insulin sensitivity after 48 weeks of treatment with metformin were important factors for weight reduction.


weight loss, type 2 diabetes, metformin, acarbose, MARCH trial

Heppner KM, Perez-Tilve D. GLP-1 based therapeutics: simultaneously combating T2DM and obesity. Front Neurosci 2015; 9: 92.
Look ARG, Wing RR, Bolin P, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes.
N Engl J Med 2013; 369: 145-54.
Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012; 35: 1364-79.
McCarty MF, DiNicolantonio JJ. Acarbose, lente carbohydrate, and prebiotics promote metabolic health and longevity by stimulating intestinal production of GLP-1. Open Heart 2015; 2: e000205.
Malin SK, Kashyap SR. Effects of metformin on weight loss: potential mechanisms. Curr Opin Endocrinol Diabetes Obes 2014; 21: 323-9.
Meneghini LF, Orozco-Beltran D, Khunti K, et al. Weight beneficial treatments for type 2 diabetes. J Clin Endocrinol Metab 2011; 96: 3337-53.
Yang W, Liu J, Shan Z, et al. Acarbose compared with metformin as initial therapy in patients with newly diagnosed type 2 diabetes: an open-label, non-inferiority randomised trial. Lancet Diabetes Endocrinol 2014; 2: 46-55.
Wang G, Liu J, Yang N, et al. MARCH2: comparative assessment of therapeutic effects of acarbose and metformin in newly diagnosed type 2 diabetes patients. PLoS One 2014; 9: e105698.
Mitri J, Hamdy O. Diabetes medications and body weight. Expert Opin Drug Saf 2009; 8: 573-84.
Mulherin AJ, Oh AH, Kim H, Grieco A, Lauffer LM, Brubaker PL. Mechanisms underlying metformin-induced secretion of glucagon-like peptide-1 from the intestinal L cell. Endocrinology 2011; 152: 4610-9.
Lindsay JR, Duffy NA, McKillop AM, et al. Inhibition of dipeptidyl peptidase IV activity by oral metformin in type 2 diabetes. Diabet Med 2005; 22: 654-7.
Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology 2007; 132: 2131-57.
Holst JJ, Vilsboll T, Deacon CF. The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol 2009; 297: 127-36.
Scrocchi LA, Brown TJ, MaClusky N, et al. Glucose intolerance but normal satiety in mice with a null mutation in the glucagon-like peptide 1 receptor gene. Nat Med 1996; 2: 1254-8.
Kreymann B, Williams G, Ghatei MA, Bloom SR. Glucagon-like peptide-1 7-36: a physiological incretin in man. Lancet 1987; 2: 1300-4.
McAdam-Marx C, Bellows BK, Unni S, et al. Determinants of glycaemic control in a practice setting: the role of weight loss and treatment adherence (The DELTA Study). Int J Clin Pract 2014; 68: 1309-17.
Nguyen KT, Billington CJ, Vella A, et al. Preserved insulin secretory capacity and weight loss are the predominant predictors of glycemic control in patients with type 2 diabetes randomized to Roux-en-Y gastric bypass. Diabetes 2015; 64: 3104-10.
Bluher M, Schweizer A, Bader G, Foley JE. Changes in body weight after 24 weeks of vildagliptin therapy as a function of fasting glucose levels in patients with type 2 diabetes. Vasc Health Risk Manag 2014; 10: 661-4.
Wang N, Zhang JP, Xing XY, et al. Associations between changes in glucagon-like peptide-1 and bodyweight reduction in patients receiving acarbose or metformin treatment. J Diabetes 2017; 9: 728-37.
Papaetis GS, Papakyriakou P, Panagiotou TN. Central obesity, type 2 diabetes and insulin: exploring a pathway full of thorns. Arch Med Sci 2015; 11: 463-82.
Ghomari-Boukhatem H, Bouchouicha A, Mekki K. Blood pressure, dyslipidemia and inflammatory factors are related to body mass index in scholar adolescents. Arch Med Sci 2017; 13: 46-52.
Yang J, Ba T, Chen L, et al. Effects of metformin and sitagliptin on glycolipid metabolism in type 2 diabetic rats on different diets. Arch Med Sci 2016; 12: 233-42.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe