Acarbose
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How this letter has changedLatest: September 2026 · Downgraded.
This record entered the Longevity Rx list in August at Grade B on STOP-NIDDM (PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 12086760) alone, and carried the not-replicated flag from the day it was written. Rule 03 places a single unrepeated randomized trial at Grade C. The letter is corrected. The evidence is unchanged: acarbose delayed conversion from impaired glucose tolerance to type 2 diabetes in one multicenter trial, there is no randomized human trial of acarbose on mortality or healthspan, and the mouse lifespan result that puts it on longevity lists moves no letter here.PMID 12086760
STOP-NIDDM (PMID 12086760) randomized adults with impaired glucose tolerance to acarbose or placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received., with conversion to type 2 diabetes as the primary endpoint The one outcome a trial names in advance as its main test. Results on other outcomes carry less weight.. One landmark trial supports B and not A under Rule 03. Acarbose appears on longevity lists because it extended median lifespan in the NIA Interventions Testing Program in mice. Animal lifespan data does not move a grade here at any effect size How large a difference the treatment made, as distinct from whether the difference could be detected at all., and there is no randomized human trial of acarbose on mortality, healthspan, or in a healthy population.PMID 12086760
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Acarbose is a diabetes drug that slows how fast the gut absorbs sugar. In two studies of people with high blood sugar, fewer developed diabetes on acarbose. The two studies were done in very different groups of people. In one, it did not lower heart problems. It appears on longevity lists because of results in mice.
A letter describes the human evidence, not the product, the manufacturer, or the intervention's worth.
Grade C: human trials exist, but they are small, mixed or not yet repeated. This is not a finding that it does not work. How to read a grade →
See the full evidence record →Prevention of progression from impaired glucose tolerance to type 2 diabetes, in two randomized trials run in different populations. The reason it appears on longevity lists is mouse lifespan data, which does not move a grade here.
Preliminary randomized evidence, small trials, or mixed results.
Acarbose 100 mg by mouth three times daily with meals, titrated from 50 mg, in adults with impaired glucose tolerance (STOP-NIDDM). The trial ran a mean of 3.3 years. Discontinuation for gastrointestinal effects was substantially higher on acarbose than placebo, which is part of what the dose means in practice.
Prescription only; requires physician management. Post-meal glucose is what the drug acts on.
Gastrointestinal effects, flatulence and diarrhea, were the dominant adverse events and the main reason participants stopped.
- PMID 12086760 →Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial.
- PMID 28917545 →Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind Neither the participants nor the people assessing them know who received the real treatment until the trial ends., placebo-controlled trial.
Primary evidenceTwo papers, each linked to its PubMed record.
Chiasson et al., STOP-NIDDM (Lancet, 2002; PMID 12086760): multicenter, placebo-controlled randomized trial of acarbose in adults with impaired glucose tolerance, with conversion to type 2 diabetes as the primary endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score.. ACE (Holman et al., Lancet Diabetes and Endocrinology, 2017; PMID 28917545): randomized, double-blind, placebo-controlled trial in 6,522 Chinese patients who had BOTH impaired glucose tolerance and established coronary heart disease. ACE found no reduction in cardiovascular events, its primary endpoint, and did report a lower incidence of type 2 diabetes. WHY THIS IS STILL A C: the two trials do not test the same population. STOP-NIDDM enrolled impaired glucose tolerance without a cardiovascular requirement; ACE required established coronary heart disease and was run entirely in China. A second trial in a different population narrows the question rather than closing it, so Rule 03's requirement for independent replication The same finding reproduced by a separate research group. A result seen once can be chance or bias; a replicated one is harder to explain away. of the same claim is not met. EBL states this rather than claiming the result stands alone. Acarbose reaches longevity lists because it extended median lifespan in the NIA Interventions Testing Program in mice. Animal lifespan data does not move a grade on this site, at any effect size. There is no randomized human trial of acarbose against mortality, healthspan or longevity, and ACE was null on cardiovascular events.
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