Tackling the Chinese diabetes epidemic
A pioneering trial coordinated by the Diabetes Trials Unit is investigating how to reduce cardiovascular risk among a Chinese population with an increasing prevalence of diabetes
Though much attention is paid to soaring levels of diabetes in the US and UK, in the last decade China has found itself facing a widespread epidemic of the disease. But a pioneering mega trial coordinated by the University of Oxford’s Diabetes Trials Unit is attempting to help, by investigating the benefit of a diabetes treatment on cardiovascular disease risk amongst those showing early signs of developing diabetes.
Figures suggest that over 90 million Chinese adults have diabetes, with a further 150 million showing early symptoms - a phenomenon sometimes referred to as prediabetes. To make that figure even more concerning, an accumulating body of evidence suggests that there is a close association between prediabetes and cardiovascular disease (CVD).
However, treating the conventional risk factors in type 2 diabetes - such as high blood pressure or being overweight - does not reduce cardiovascular risk in prediabetics to the same level as in a non-diabetic population. Instead, it has been reported through small studies that reducing post-prandial hyperglycaemia with with the anti-diabetic drug acarbose can reduce CVD risk in those patients. What remains unclear, however, is the exact impact on new CVD events in individuals with existing CVD and prediabetes.
That is where the Diabetes Trials Unit-led Acarbose Cardiovascular Evaluation (ACE) trial comes in. A double-blind, randomised, multi-centre study, ACE is a pioneering collaboration between the University of Oxford and Chinese teaching hospitals. Designed by Professors Rury Holman (Oxford University, UK), Hu Dayi (People's Hospital Peking University, China) and Pan Chang Yu (Chinese PLA General Hospital, Beijing, China), it could hold the key to reducing CVD risk amongst an increasingly diabetic Chinese population.
ACE aims to recruit 7,500 patients who have both cardiovascular disease and impaired glucose tolerance in order to asses how useful the addition of acarbose - a drug which inhibits enzymes, specifically glycoside hydrolases - is to usual care. Ultimately, the trial will assess whether acarbose therapy can reduce cardiovascular-related morbidity and mortality in patients with prediabetes and established cardiovascular disease. The study will also determine if acarbose therapy can prevent or delay the onset of type 2 diabetes mellitus in the same patient population.
ACE is being conducted across 150 hospitals in mainland China and Hong Kong, and started officially in 2008, with participating hospitals being managed \through a specifically developed ACE Project Office in Beijing. Patients in the trial will be followed for a minimum of 4 years, which means that the results are expected in 2016. The results could well make a big difference to a nation coming to terms with widespread diabetes.
Figures suggest that over 90 million Chinese adults have diabetes, with a further 150 million showing early symptoms - a phenomenon sometimes referred to as prediabetes. To make that figure even more concerning, an accumulating body of evidence suggests that there is a close association between prediabetes and cardiovascular disease (CVD).
However, treating the conventional risk factors in type 2 diabetes - such as high blood pressure or being overweight - does not reduce cardiovascular risk in prediabetics to the same level as in a non-diabetic population. Instead, it has been reported through small studies that reducing post-prandial hyperglycaemia with with the anti-diabetic drug acarbose can reduce CVD risk in those patients. What remains unclear, however, is the exact impact on new CVD events in individuals with existing CVD and prediabetes.
That is where the Diabetes Trials Unit-led Acarbose Cardiovascular Evaluation (ACE) trial comes in. A double-blind, randomised, multi-centre study, ACE is a pioneering collaboration between the University of Oxford and Chinese teaching hospitals. Designed by Professors Rury Holman (Oxford University, UK), Hu Dayi (People's Hospital Peking University, China) and Pan Chang Yu (Chinese PLA General Hospital, Beijing, China), it could hold the key to reducing CVD risk amongst an increasingly diabetic Chinese population.
ACE aims to recruit 7,500 patients who have both cardiovascular disease and impaired glucose tolerance in order to asses how useful the addition of acarbose - a drug which inhibits enzymes, specifically glycoside hydrolases - is to usual care. Ultimately, the trial will assess whether acarbose therapy can reduce cardiovascular-related morbidity and mortality in patients with prediabetes and established cardiovascular disease. The study will also determine if acarbose therapy can prevent or delay the onset of type 2 diabetes mellitus in the same patient population.
ACE is being conducted across 150 hospitals in mainland China and Hong Kong, and started officially in 2008, with participating hospitals being managed \through a specifically developed ACE Project Office in Beijing. Patients in the trial will be followed for a minimum of 4 years, which means that the results are expected in 2016. The results could well make a big difference to a nation coming to terms with widespread diabetes.
