Last updated on July 28th, 2023
Alpha-glucosidase inhibitors are anti-diabetes drugs useful in the treatment of type 2 diabetes. Two medicines fall in this group namely, miglitol and acarbose. The medications aid in keeping the quantity of sugar in the bloodstream from rising too quickly after a person eats.
A healthcare provider may recommend an alpha-glucosidase inhibitor if a person is recently diagnosed with type 2. The level of blood sugar is expected to increase after eating food. If a person is already consuming anti-diabetes medicines and still experiencing high blood glucose, a doctor may need a person to consume an alpha-glucosidase inhibitor, as well. This class of anti-diabetics generally reduces a person’s A1c (the “average” of blood glucose control over some months) by nearly 0.5-0.8%.
What are Alpha-glucosidase Inhibitors?
These are oral diabetes medications used for regulating high blood glucose in type 2 diabetic patients. This is true in people whose diabetes is not regulated by diet alone. Type 2 diabetes is a health problem in which a person’s body fails to utilize insulin usually. And, thus can’t regulate the quantity of glucose in a person’s blood.
Gradually, diabetic patients may develop severe or dangerous complications. These may include cardiac problems, stroke, eye diseases, kidney ailments, nerve damage (reduced sexual ability in males and females, numbness, cold legs, or feet), etc. Medicines in combination with lifestyle modifications (diet, physical activity, and quitting smoking) and consistent check-ups of blood glucose might aid in diabetes management. Also, glucosidase inhibitors aid in improving health, preventing a stroke or heart attack, or other diabetes-associated complications.
- Acarbose: It is an adjunct to diet and physical activity. This medication helps in improving glycemic control in type 2 diabetic patients.
- Miglitol: The medication is an adjunct to diet and exercise to improve the blood sugar levels in type 2 diabetics.
Also Read: Homeopathic Medicines For Diabetes
AGIs in Diabetes
Alpha-glucosidase inhibitors help lower postprandial diabetes (after-meal high blood sugars). These medications reasonably reduce the levels of glycosylated hemoglobin and also lower the concentration of postprandial insulin. In contrast to oral anti-diabetes medicines, they also decrease glucose inconsistency during the day. Yet, they do not affect the fasting insulin and serum triglyceride amounts.
Regulation of post-meal hyperglycemia is vital as it associates with the development of complications and also augments the risk of heart problems. This association between postprandial blood glucose (PPG) and chronic diabetic complications becomes more powerful than fasting high blood sugars.
Acarbose has been found to augment the life expectancy in type 2 diabetic patients. Additionally, the medicine lowers the risk of cardiovascular events in people having impaired glucose tolerance. The medication has proven effective in alleviating carotid plaques. This is possible by lowering the high glucose levels. Also, Acarbose has been seen to counter oxidative stress and endothelial impairment.
Read About: Effect of Eating Watermelons on Diabetics
Alpha-glucosidase Inhibitors Mechanism of Action
Alpha-glucosidase inhibitors act by blocking the breakdown of starchy food products including potatoes, bread, pasta, etc. Also, these drugs delay the absorption of a few sugars like table sugar. Alpha-glucosidase inhibitor drugs are prescription-only medications. And, people administer by oral route. People take this class of medicines thrice a day.
Alpha-glucosidase inhibitors block the breakdown of complex carbs into sugar. Also, people can use these medications for building a higher glycemic control. This is possible by preventing the digestion of carbs (such as disaccharides, polysaccharides, and oligosaccharides) into monosaccharides which get absorbed by a person’s body simply.
Alpha-glucosidase Inhibitors Names
- Precose (Acarbose): Precose helps treat type 2 diabetes. The medication shows its action by dissolving the carbs present in the GIT to regulate blood glucose after a meal. This prescription-only drug needs to be combined with diet and exercise to maintain a healthy lifestyle. It comes in a tablet form with dose strengths of 25 mg, 50 mg, and 100 mg.
- Glyset (Miglitol): Same are the uses of this medication as above. It also comes in doses of 25 mg, 50 mg, and 100 mg.
Also Read: Glycomet Diabetes Medication
People take this class of drugs via the oral route. The dose of Alpha-glucosidase inhibitors is thrice a day with the initial bite of every meal. The usual suggestion is, to begin with, a lower dose. This helps in lowering the frequency of side effects. And, the second reason is to attain the anticipated dose for attaining optimal glycemic control.
The ideal starting dose of Acarbose is 25 mg thrice each day. Then, titrating it afterward every four to eight weeks. And, the maximum dose of this anti-diabetic reaches 100 mg thrice a day. For Voglibose, the suggested starting dose is 0.2 mg thrice on a daily basis. This may be augmented to 0.3 mg thrice on a daily basis. Also, for Miglitol, the starting dosage is 25 mg thrice daily. Also, its maximum dose goes up to 100 mg three times each day.
The safety of alpha-glucosidase inhibitors is not established in kids and pregnant females. The efficiency of these medications is affected by the number of complex carbs in the diet. Also, a carb-rich diet augments the severity of GIT’s adverse effects.
A person can consume alpha-glucosidase inhibitors along with an initial bite of every meal. Many individuals consume a tablet thrice a day.
Also Read: Diabetes and Jaggery
If a person is also consuming other anti-diabetic drugs or insulin, check with a healthcare provider about how likely a person would experience low blood sugars. If a person is only consuming an alpha-glucosidase inhibitor, he or she possibly won’t experience low blood glucose levels.
A healthcare provider may begin off with a low dose and then increase it for a moment. This aids in preventing trouble in the gut including:
- Passing gas
- Abdominal pain
- Upset stomach
These side effects would generally fade away in some weeks. Visit a healthcare provider if they do not.
GI troubles are the most common side effects of alpha-glucosidase inhibitors. Also, diarrhea, abdominal pain, and flatulence are common.
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Alpha-glucosidase inhibitor drugs are not beneficial for people with:
- A digestive problem related to the intestines
- An inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
- An obstruction in the intestines
- Diabetic ketoacidosis is a hazardous health problem in which a person’s body burns fat in place of carbohydrates for energy
Other contraindications of Alpha-glucosidase inhibitor drugs include:
- Long-term intestinal disease
- Colonic ulceration
- Any known allergy to this group of drugs.
A person must not consume Acarbose if he or she has:
- Cirrhosis of the liver
- An ulcer in the large intestine
- Also, these medications are not advisable for pregnant females.
Alpha-glucosidase inhibitor drugs are contraindicated in medical problems that deteriorate because of too much production of gas in the gut. Also, these medications are not good for people who experience intestinal obstruction.
Also Read: Yoga For Diabetes
Alpha-glucosidase Inhibitors Benefits
These medications come with the benefits of lowering post-meal blood glucose levels. And, hence aids in reducing the levels of HbA1c, chiefly when combined with other diabetes drugs. In addition, they also elevate the post-meal levels of a hormone, GLP-1. This hormone aids in slowing down the digestive processes and reduces appetite. This implies that they fail to augment the probability of weight gain, contrasting to other classes like thiazolidinediones or sulphonylureas.
AGIs augment the levels of GLP-1 after eating. It is an incretin hormone that delays digestion, reduces appetite, and keeps a person feeling fuller more rapidly throughout a meal. Hence, Acarbose helps to promote weight loss.
Read More: Home Remedies To Cure Diabetes
Are Alpha-glucosidase Medications Safe?
In rare cases, the use of Acarbose has been established to cause acute hepatitis. It is better to perform liver function tests prior to starting therapy and during treatment with the medicine.
Digestive enzyme drugs comprising carb-splitting enzymes like amylase or pancreatin might decrease the effect of AGIs. Thus, it is suggested not to take them in combination. Medications for digesting food (like Pancrease) must not be consumed at the same time as Miglitol.
Some medications may have an effect on how Acarbose works. Hence, they should not be taken with Acarbose. These medications are:
- Calcium channel blocker
- Phenothiazines like promethazine, chlorpromazine
- Cold or allergy medications
- Oral contraceptives
- Steroid medications
- Thyroid medications
- Keep all the medications out of the reach of kids. Never share medication with any other person.
- Inform a healthcare provider if a female is pregnant or breastfeeding before taking these medicines.
- Also, in case of kidney disorder, or any condition related to bowels, it is good to inform a doctor before taking AGIs.
- A person might require to keep glucose tablets or gel handy in case of very low blood glucose levels. Table sugar might not work too, as Acarbose keeps a person’s body from absorbing regular glucose swiftly.
Special Precautionary Tips
- Keep consuming AGIs even if an individual thinks that their glucose levels are under control. If a person misses a dose, do not take a larger dose, speak to a doctor instead.
- It is vital to consume short recurrent meals, do not fast for long periods while on these medications. Beware of low blood glucose symptoms like:
- Shaking or shivers
- Dry skin
- Intense thirst
- Perspiration, faintness
- Dry mouth
- Often urination etc.
- Whenever individual experiences these above symptoms, directly take 5-6 candies or any other glucose source. These items should be in hand, especially during long travels.
- Quit smoking.
- Reduce the consumption of carb-rich foods. These include mangoes, bread, potato, rice, etc.
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Read More: Diabetic Diet Chart Indian
Why does Acarbose result in diarrhea?
The medication rarely results in diarrhea. Acarbose-linked colitis has been established. Due to inhibition of alpha-glucosidase, a high amount of starch reaches the colon.
Why is there a contraindication of AGIs in inflammatory bowel disease?
AGIs competitively block enzymes concerned with carb digestion. Higher production of gas in the intestines because of fermentation of the undigested carbs may deteriorate or worsen intestinal issues.
Is it safe to taken an overdose of Acarbose?
If you consume Acarbose in excess, visit a doctor or local Poison Control Center immediately. If Acarbose is given by a doctor in a medical setting, it is not likely that an overdose would take place.
How efficacious are AGIs?
In a Cochrane meta-analysis, AGIs were seen to lower the glycated Hb by 0.8% than a placebo.
Last Updated on by Dr. Damanjit Duggal
The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.