Alpha glucosidase inhibitors

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The alpha-glucosidase inhibitors acarbose, miglitol, voglibose have been studied extensively in Europe and Japan; two of them, acarbose and miglitol, are available in the United States. Taken orally, they inhibit the upper gastrointestinal enzymes alpha-glucosidases that convert complex polysaccharide carbohydrates into monosaccharides in a dose-dependent fashion. These drugs therefore slow the absorption of dietary carbohydrate; the slower rise in postprandial blood glucose concentrations is potentially beneficial in both type 1 and type 2 diabetes. In addition, the transfer of polysaccharides to the more distal small intestine increases the secretion of glucagon-like peptide 1 GLP-1 and several other gut hormones [ 1 ]. In older patients with type 2 diabetes, acarbose may also increase insulin sensitivity [ 2 ], although this may have been a nonspecific effect associated with improved glycemia. Alpha-glucosidase inhibitors do not cause hypoglycemia when used as monotherapy or with other agents that do not cause hypoglycemia.

Alpha glucosidase inhibitors

Cardiovascular Diabetology volume 18 , Article number: Cite this article. Metrics details. Alpha-glucosidase inhibitors AGIs have been shown to reduce incident type 2 diabetes but their impact on cardiovascular CV disease remains controversial. Of ten trials identified, three met our inclusion criteria for incident type 2 diabetes and four were eligible for CV outcomes. There was little to no heterogeneity between studies, with I 2 values of 0. Alpha-glucosidase inhibitors AGIs such as acarbose, miglitol and voglibose are oral drugs used in the management of diabetes, primarily to reduce post-prandial glucose concentrations. Their use in individuals with impaired glucose tolerance IGT has been shown to delay progression to diabetes, but their effects on cardiovascular CV outcomes remain uncertain [ 1 ]. A previous systematic review evaluated the effects of acarbose on various outcomes, including CV, but it did not include a meta-analysis of randomized controlled trials [ 2 ]. Similarly, a meta-analysis of seven studies conducted between and reported a reduction in myocardial infarction MI in individuals assigned acarbose compared with placebo, but was based on only 28 events [ 4 ]. The recently completed Acarbose Cardiovascular Evaluation ACE trial [ 5 ] was a randomized, double-blind, placebo-controlled, phase 4 study conducted in China that recruited patients with coronary heart disease and IGT. Participants were randomly allocated to acarbose 50 mg three times daily or placebo, given in addition to fully-optimized CV secondary prevention therapy.

Miglitol is fairly well absorbed by the body, as opposed to acarbose. Their use in individuals with impaired glucose tolerance IGT has been shown to delay progression to diabetes, but their effects on cardiovascular CV outcomes remain uncertain [ 1 ]. Other contraindications include diabetic ketoacidosis, chronic intestinal disease, colonic ulceration, inflammatory bowel disease, alpha glucosidase inhibitors known hypersensitivity to this group of drugs.

There is only one tablet of this type used, called acarbose. It is usually used when a healthy diet and physical activity alone has been unsuccessful, although it is sometimes used together with a sulphonylurea. Acarbose works by slowing down the absorption of starchy foods from the intestine. This means that blood glucose levels rise more slowly after meals. Acarbose should always be chewed with the first mouthful of food or swallowed whole with a little liquid immediately before the meal. All medication has side effects and you should check the patient information leaflet PIL supplied with your medication to see which side effects you might experience from your particular medication.

Federal government websites often end in. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. NCBI Bookshelf. Alpha glucosidase is an intestinal brush border enzyme responsible for the hydrolysis of disaccharides which is necessary for the absorption of starch, dextrins and disaccharides. Inhibition of this enzyme causes malabsorption and slowing of absorption of carbohydrates and decreases the postprandial rise in blood glucose. These drugs may also increase the release of glucagon-like peptide-1 GLP-1 which may contribute to their glucosing lowering effects. Alpha glucosidase inhibitors have been shown to be effective in improving glycemic control in type 2 diabetes. Two alpha glucosidase inhibitors have been approved for use in the United States, acarbose Precose in and miglitol Glyset in

Alpha glucosidase inhibitors

Alpha-glucosidase inhibitors AGIs are oral anti-diabetic drugs used for diabetes mellitus type 2 that work by preventing the digestion of carbohydrates such as starch and table sugar. Carbohydrates are normally converted into simple sugars monosaccharides by alpha-glucosidase enzymes present on cells lining the intestine, enabling monosaccharides to be absorbed through the intestine. Hence, alpha-glucosidase inhibitors reduce the impact of dietary carbohydrates on blood sugar.

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They may play a role as part of a combination regimen in people who consume high-carbohydrate diets and have high postprandial glucose levels, as long as the gastrointestinal side effects are tolerated. We conducted a meta-analysis of randomized placebo-controlled trials of AGIs in populations with IGT or type 2 diabetes, with or without established CV disease. Epub Nov Alpha-glucosidase inhibitors AGIs are a class of drugs that are used in the treatment of type 2 diabetes mellitus alone or combined with other antidiabetic drugs. Regular insulin. They should be taken three times a day with the first bite of each meal. Epub Jul Sorry, a shareable link is not currently available for this article. In older patients with type 2 diabetes, acarbose may also increase insulin sensitivity [ 2 ], although this may have been a nonspecific effect associated with improved glycemia. Diarrhea and abdominal pain may also occur.

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Alpha-glucosidase inhibitors AGIs such as acarbose, miglitol and voglibose are oral drugs used in the management of diabetes, primarily to reduce post-prandial glucose concentrations. Why UpToDate? If you do, speak to your doctor as there may be another diabetes medication you could try instead. Our literature search identified articles, of which there were ten trials that met the criteria for possible inclusion in the incident diabetes meta-analysis Fig. The membrane-bound intestinal alpha-glucosidases hydrolyze oligosaccharides , trisaccharides , and disaccharides to glucose and other monosaccharides in the small intestine. Pneumatosis cystoides intestinalis is another reported side effect. Their use in individuals with impaired glucose tolerance IGT has been shown to delay progression to diabetes, but their effects on cardiovascular CV outcomes remain uncertain [ 1 ]. The recently completed Acarbose Cardiovascular Evaluation ACE trial [ 5 ] was a randomized, double-blind, placebo-controlled, phase 4 study conducted in China that recruited patients with coronary heart disease and IGT. In older patients with type 2 diabetes, acarbose may also increase insulin sensitivity [ 2 ], although this may have been a nonspecific effect associated with improved glycemia. Select the option that best describes you. Results Incident diabetes Our literature search identified articles, of which there were ten trials that met the criteria for possible inclusion in the incident diabetes meta-analysis Fig.