Acarbose

A complex oligosaccharide called acarbose slows down the digestion of consumed carbs, causing a lesser increase in blood glucose levels after meals. Acarbose lowers levels of glycosylated hemoglobin in people with type 2 diabetes mellitus as a result of lowering plasma glucose. Levels of glycosylated hemoglobin, which are a measure of systemic non-enzymatic protein glycosylation, depend on the average blood glucose level throughout time. Acarbose does not increase insulin secretion as sulfonylureas do. Acarbose’s antihyperglycemic effect is caused by a competitive, reversible suppression of intestinal alpha-glucoside hydrolase enzymes that are membrane-bound and pancreatic alpha-amylase. The membrane-bound intestinal alpha-glucosidases hydrolyze oligosaccharides, trisaccharides, and disaccharides to glucose and other monosaccharides in the brush border of the small intestine, while pancreatic alpha-amylase hydrolyzes complex starches to oligosaccharides in the lumen of the small intestine. This enzyme inhibition in diabetic patients delays the absorption of glucose and lowers postprandial hyperglycemia.

Acarbose’s ability to improve glycemic control when combined with sulfonylureas, insulin, or metformin is additive because of its unique method of action. Acarbose also lessens the impact of sulfonylureas’ insulinotropic and weight-increasing actions.

Since acarbose has a little inhibitory effect against lactase, it is not anticipated that it would cause lactose intolerance.

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