Monotherapy with DPP-IV inhibitors, SGLT-2 inhibitors or insulin secretagogues frequently failed to maintain blood glucose in patients with type 2 diabtes. It was critical to determine which was more suitable of acarbose versus metformin plus pioglitazone.

Inclusion Criteria:

• Willing to participate in this present study;
• Patients with type 2 diabetes receiving stable monotherapy of DPP-IV inhibitors, SGLT-2 inhibitors or insulin secretagogues for more than 3 months;
• Screening glycated hemoglobin (HbA1c) between 7.0% and 10.0%;
• Regular diet and exercise;
• Body mass index (BMI) ≥ 18.5 kg/m2

Exclusion Criteria:

• Intolerance of metformin, pioglitazone and acarbose;
• Severe liver disease or elevated transaminases (2.5-fold the upper limit);
• Renal dysfunction or elevated creatinine (1.3-fold the upper limit);
• Systemic steroids therapy or other medication influencing cholesterol metabolism in the past 3 months;
• Infection or stress state in the past 4 weeks;
• Pregnancy or lactation;
• Patients otherwise adjudged by the investigator to be inappropriate for inclusion into the study.