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Acarbose — an α-glucosidase inhibitor that delays intestinal glucose absorption and reduces postprandial hyperglycemia — was FDA-approved in 1995 but never really caught on in the U.S. for treating patients with type 2 diabetes. Its effect on glycosylated hemoglobin is relatively modest, it must be taken thrice daily with meals, and it frequently causes flatulence or diarrhea. However, an older study of patients with impaired glucose tolerance suggested that acarbose might confer cardiovascular benefits (NEJM JW Gen Med Sep 1 2003 and JAMA 2003; 290:486). Now, Taiwan researchers present results of an observational study in which either acarbose or sulfonylurea was added to metformin in type 2 diabetic patients. Through propensity scoring, t…