Would you take a pill that would help protect you from heart problems eventually, but raise your risk for the next year? That’s the intriguing question raised by a major drug study involving more than 100,000 diabetic patients.

The drug, acarbose, is used to treat type 2 diabetes. Acarbose works by slowing the chemical breakdown of food you eat, which also slows the release of glucose from that food into your bloodstream. It is typically taken at the beginning of meals, helping to decrease postprandial hyperglycemia—a spike in your blood sugar levels after eating.

Over the years, several studies have shown that acarbose may also provide a second benefit: reducing the risk of cardiovascular events in diabetic patients. But most of these studies were of limited size and quality.

The latest word comes from what is by far the largest and most authoritative study of its kind. Researchers in Taiwan reviewed records of 644,792 patients who had been newly diagnosed with type 2 diabetes and who had not been diagnosed with cardiovascular disease (CVD). From this group, they identified 109,139 patients who had taken acarbose and were analyzed for CVD risk.

And that’s when things got interesting.

Over a seven-year follow-up period, a surprising trend emerged. After twelve months of use, acarbose dramatically reduced the patients’ risk of cardiovascular disease. But the drug had the opposite effect during the first twelve months it was taken—actually raising the risk of cardiovascular disease.

The same results were found whether acarbose was taken alone or in combination with other medications.

The heart of the matter

Heart disease is a special concern for people with diabetes. Having either type 1 or type 2 diabetes or prediabetes increases the risk of a heart attack or stroke. Maintaining good blood sugar control through diet, exercise, and medications if needed will reduce that risk.

So why did a drug proven to help control diabetes appear to have such contradictory effects on heart health? Such questions will have no answers until further research is done —a distant prospect at this point.

What to do

What should you do if you take acarbose or if your doctor recommends it? Every patient is different. Your doctor is in the best position to evaluate whether the potential benefits of acarbose outweigh the risks in your case. Discuss your concerns, and make sure he or she is aware of the latest research. And never stop taking acarbose or any other prescribed medicine without talking it over with your doctor.

Acarbose is also sold as the name-brand medications Prandase, Precose, and Glucobay.

To learn more about oral diabetes medications:
Pills: Just One Tool - Not a Diabetes Cure-All
When to Update or Change Your Diabetes Medications
Take Your Damn Meds!