Weight Loss with Acarbose and Metformin May be Curative in Early Phases of Diabetes Mellitus

Background: Atherosclerosis may be the main cause of diabetes mellitus (DM). Methods: All patients with sickle cell diseases (SCD) were included. Results: We studied 222 males and 212 females with similar ages (30.8 vs 30.3 years, p>0.05, respectively). Smoking (23.8% vs 6.1%, p<0.001), alcohol (4.9% vs 0.4%, p<0.001), transfused red blood cells (RBC) in their lives (48.1 vs 28.5 units, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), stroke (12.1% vs 7.5%, p<0.05), chronic renal disease (CRD) (9.9% vs 6.1%, p<0.05), cirrhosis (8.1% vs 1.8%, p<0.001), chronic obstructive pulmonary disease (25.2% vs 7.0%, p<0.001), coronary heart disease (18.0% vs 13.2%, p<0.05), leg ulcers (19.8% vs 7.0%, p<0.001), and clubbing (14.8% vs 6.6%, p<0.001) were all higher in males. Conclusion: As an accelerated atherosclerotic process, hardened RBC-induced capillary endothelial damage terminates with multiorgan insufficiencies in early decades in the SCD. Although atherosclerotic endpoints are common, we detected no case of DM probably due to lower body mass indexes. As the most common cause of CRD, DM may be an atherosclerotic endpoint, too. Increased blood and insulin needs of excess fat tissue in contrast to decreased blood supply of the excess tissue and pancreas both due to excess pressure on vasculature, externally and atherosclerosis, internally may be significant in the development of DM. Acarbose and metformin are safe, cheap, oral, long-term used, and effective drugs for loss of excess fat which may even be curative in early phases of DM before development of fibrotic changes on vasculature.