Diabetes Oral Drugs - Alpha Glucosidase Inhibitors

Diabetes Oral Drugs - Alpha Glucosidase Inhibitors

Diabetes medications fall in two broad classes. Oral Pills and Injectables. Oral pills fall in different classes of drugs depending upon the mode of action and will be covering details about Alpha Glucosidase Inhibitors anti-hyperglycemic drugs here.

Background:

The first alpha glucosidase inhibitor to get FDA approval in USA was Acarbose in 1995. Miglitol followed in 1999. Voglibose is the latest addition.

Mode Of Action:

Alpha glucosidase inhibitors slow down the digestion and absorption of carbohydrates by blocking the enzyme alpha glucosidase, which helps in digesting carbohydrates in the small intestine. This slowing down of absorption causes the blood sugar level to peak less after  a carbohydrate rich meal and therefore aids in a better blood sugar control.

Both Voglibose and acarbose, associated with an in increase in glucagon like peptide (GLP-1), which has insulinotropic effect and which has inhibitory effect on glucagon secretion, which results in overall reduction postprandial hyperglycemia. (source).

Beta blocker, salicylates, Fibrates and epinephrine can increase antihyperglycemic effect so concomitant administration should be avoided

Other Benefits:
  1. No risk for hypoglycemia
  2. No weight gain
Side Effects:
  1. Nausea
  2. Flatulence
  3. Diarrhoea
  4. Stomach ache
  5. Disruption of normal microbiome (more research needed to know all the effects)
Contraindications
  1. patients in DKA (diabetic ketoacidosis)
  2. patients with IBS, Ulcerative Colitis, acute bowel obstruction or any chronic intestinal disease which may worsen due to the increased gas formation in the intestine.
Brands ( generic name in brackets)

Glucobay, Diabose, Acarb, in US Precose(Acarbose)

Elitox, Euglitol, Miglit, in US Glyset ( Miglitol)

Vocarb, Zibose, Voglicon, Volix,in US Voglib (Voglibose)

References
  1. Mastering your diabetes by dr Mona Morstein
  2. webmd.com

 

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