Effects of beraprost sodium, an oral prostacyclin analog, on insulin resistance in patients with type 2 diabetes

Beraprost sodium (BPS) is an orally active prostacyclin analog that is widely used in the treatment of atherosclerotic peripheral arterial disease (PAD). The aim of this study was to evaluate the effects of BPS on the insulin resistance in type 2 diabetic patients with PAD. A euglycemic-hyperinsulinemic clamp study was performed to determine the insulin sensitivity (based on the M/I ratio) before and after 12 weeks’ BPS treatment in 14 patients (12 men; mean age, 68.7 ± 5.5 years) with type 2 diabetes and PAD. While there was no significant change of the BMI or waist circumference, a tendency towards improvement of the M/I ratio and decrease of the HbA1c and serum triglyceride level was observed. Subgroup analyses revealed that the improvement of the M/I ratio was more pronounced in the subgroups with a higher serum triglyceride level and lower value of the M/I ratio at the baseline. Our findings suggest that BPS may improve the insulin resistance in diabetic patients, especially in those with greater degrees of insulin resistance.