Mehmet Rami Helvaci¹*, Emine Helvaci², Irem Sultan Kamalak², Yusuf Aydin¹, Leyla Yilmaz Aydin³, Alper Sevinc¹, Celaletdin Camci¹, Abdulrazak Abyad⁴ and Lesley Pocock⁵

¹Specialist of Internal Medicine, MD, Turkey
²Manager of Writing and Statistics, Turkey
³Specialist of Pulmonary Medicine, MD, Turkey
⁴Middle-East Academy for Medicine of Aging, MD, Lebanon
⁵Medi-WORLD International, Australia

*Corresponding Author: Mehmet Rami Helvaci, Professor, Specialist of Internal Medicine, MD, Turkey.

Received: August 13, 2025; Published: October 26, 2025

Abstract

Background: Atherosclerotic endpoints may be the major cause of aging and shortened survival in human being.

Methods: All patients with sickle cell diseases (SCD) were included into the study.

Results: We studied 222 males and 212 females with similar mean ages of 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 digital clubbing (14.8% vs 6.6%, p < 0.001) were all higher in males, significantly.

Conclusion: As an accelerated atherosclerotic process, hardened RBC-induced capillary endothelial damage initiated at birth terminates with multiorgan failures in early decades of life in the SCD. Excess fat tissue may be much more significant than smoking and alcohol for atherosclerotic endpoints since excess fat tissue-induced diabetes mellitus is the most common cause of the CRD in human being. The efficacy of acarbose to lower blood glucose by preventing breakdown of starch into sugar in the small intestine is well-known. Since acarbose is a safe, cheap, oral, long-term used, and non failed drug for excess fat, and since acarbose intolerance is significantly lower than metformin in the society, acarbose should be the first-line antidiabetic agent, clinically.

Keywords: Sickle Cell Diseases; Acarbose; Metformin; Excess Fat Tissue; Capillary Endothelial İnflammation; Atherosclerotic Endpoints; Diabetes Mellitus

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Citation

Citation: Mehmet Rami Helvaci., et al. “Acarbose Should be the First-Line Antidiabetic Agent".Acta Scientific Gastrointestinal Disorders 8.11 (2025): 07-22.

Copyright

Copyright: © 2025 Mehmet Rami Helvaci., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.