Trial reportDiabetes research and clinical practice2025

Baseline glucagon impacts glucose-lowering effects of acarbose but not metformin: A sub-analysis of MARCH study.

Lanxuan Jiang, Liyuan Zhou, Jia Liu, Guang Wang

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Diabetes research and clinical practice, 2025. The graph read 4 numbers from its abstract, feeding 1 cell of the map: it . Cited by 1 paper.

4numbers the graph read from it
1cell of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
-1.320 · no effect
HbA1c reductionsacarbose vs acarbose (low glucagon subgroup), in high baseline glucagonfavours the treatment · t2dfeeds one cell of the map
Δ -1.32< 0.05
In the acarbose group, higher baseline glucagon levels correlated with greater HbA1c reductions at 24 weeks (-1.32 % for high and -1.27 % for medium vs. -0.87 % for low; both P < 0.05) and at 48 weeks (-1.23 % for high and -1.30 % for medium vs. -0.79 % for low; both P < 0.05), while metformin showed consistent glucose-lowering effects across all glucagon subgroups.
HbA1c reductionsacarbose vs acarbose (low glucagon subgroup), in medium baseline glucagonfavours the treatment · t2dfeeds one cell of the map
Δ -1.27< 0.05
In the acarbose group, higher baseline glucagon levels correlated with greater HbA1c reductions at 24 weeks (-1.32 % for high and -1.27 % for medium vs. -0.87 % for low; both P < 0.05) and at 48 weeks (-1.23 % for high and -1.30 % for medium vs. -0.79 % for low; both P < 0.05), while metformin showed consistent glucose-lowering effects across all glucagon subgroups.
HbA1c reductionsacarbose vs acarbose (low glucagon subgroup), in medium baseline glucagonfavours the treatment · t2dfeeds one cell of the map
Δ -1.30< 0.05
In the acarbose group, higher baseline glucagon levels correlated with greater HbA1c reductions at 24 weeks (-1.32 % for high and -1.27 % for medium vs. -0.87 % for low; both P < 0.05) and at 48 weeks (-1.23 % for high and -1.30 % for medium vs. -0.79 % for low; both P < 0.05), while metformin showed consistent glucose-lowering effects across all glucagon subgroups.
HbA1c reductionsacarbose vs acarbose (low glucagon subgroup), in high baseline glucagonfavours the treatment · t2dfeeds one cell of the map
Δ -1.23< 0.05
In the acarbose group, higher baseline glucagon levels correlated with greater HbA1c reductions at 24 weeks (-1.32 % for high and -1.27 % for medium vs. -0.87 % for low; both P < 0.05) and at 48 weeks (-1.23 % for high and -1.30 % for medium vs. -0.79 % for low; both P < 0.05), while metformin showed consistent glucose-lowering effects across all glucagon subgroups.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Other glucose-lowering×glycemic control

No readable resultOpen on the map →What to test next →

8 readable studies in this cell: 4 favour the treatment, 0 find no difference, 4 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2025
Δ -1.32
NCT017093055,570 enrolled · 2012
Δ 0.190.02 to 0.36
NCT050350821,018 enrolled · 2021
Δ -0.24-0.44 to -0.04
placebo-subtracted decrease -0.44
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

4 authors.

Lanxuan JiangDepartment of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.
Liyuan ZhouDepartment of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.
Jia LiuDepartment of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China. Electronic address: liujia0116@126.com.
Guang WangDepartment of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China. Electronic address: wangguangcy@ccmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundThe impact of glucagon on glucose-lowering therapies remains unclear. This study evaluated the effect of baseline glucagon levels on acarbose and metformin efficacy in newly diagnosed type 2 diabetes.

methodsA sub-analysis of the MARCH trial was conducted, involving 493 patients randomly assigned to receive either acarbose (300 mg/day) or metformin (1500 mg/day) for 48 weeks. Participants were grouped into low, medium, and high glucagon based on baseline tertiles. The primary outcome was changes in glycated hemoglobin A1c (HbA1c) at 24 and 48 weeks.

resultsSignificant reductions in HbA1c were observed in both acarbose and metformin groups at 24 and 48 weeks. In the acarbose group, higher baseline glucagon levels correlated with greater HbA1c reductions at 24 weeks (-1.32 % for high and -1.27 % for medium vs. -0.87 % for low; both P < 0.05) and at 48 weeks (-1.23 % for high and -1.30 % for medium vs. -0.79 % for low; both P < 0.05), while metformin showed consistent glucose-lowering effects across all glucagon subgroups.

conclusionHigher baseline glucagon significantly enhanced the glucose-lowering efficacy of acarbose but not metformin, suggesting glucagon could guide personalized diabetes treatment.

Indexed as

AcarboseBlood GlucoseDiabetes Mellitus, Type 2GlucagonHypoglycemic AgentsMetforminAdultAgedFemaleGlycated HemoglobinHumansMaleMiddle AgedAcarboseBlood GlucoseGlucagonGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsMetforminAcarboseGlucagonHbA1cMetformin

Identifiers

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.