Alpha glucosidase inhibitors

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, alpha glucosidase inhibitors. Acarbose works by slowing down the absorption of starchy foods from the intestine.

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

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.

Inhibition of these enzyme systems reduces the rate of digestion of carbohydrates.

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. Manahil Akmal ; Roopma Wadhwa. Authors Manahil Akmal ; Roopma Wadhwa 1. Alpha-glucosidase inhibitors AGIs are a group of antidiabetic drugs used for the management of type 2 diabetes mellitus.

There's more to see -- the rest of this topic is available only to subscribers. Renew my subscription. Not now - I'd like more time to decide. Tags Type your tag names separated by a space and hit enter. Search Johns Hopkins Diabetes Guide. Alpha Glucosidase Inhibitors. Alona Crowder, Pharm.

Alpha glucosidase inhibitors

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. Manahil Akmal ; Roopma Wadhwa.

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PubMed Google Scholar Download references. Guidelines published by the Cochrane Collaboration for the conduct of a meta-analysis and the PRISMA checklist [ 6 ] for reporting were followed to ensure best practice. Trials reporting CV outcomes were required to include as a minimum all three components of a major adverse cardiovascular event MACE-3 composite outcome defined as CV death, non-fatal MI or non-fatal stroke. Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes. 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. Download as PDF Printable version. ISBN Of the articles identified in the literature search, there were ten trials that met the criteria for possible inclusion in the CV outcomes meta-analysis Fig. Effects of alpha-glucosidase-inhibiting drugs on acute postprandial glucose and insulin responses: a systematic review and meta-analysis. Other oral hypoglycemic drugs are reviewed separately. In diabetic patients, the short-term effect of these drugs therapies is to decrease current blood glucose levels: the long-term effect is a small reduction in hemoglobin A1c level.

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Since these effects are dose-related, it is generally advised to start with a low dose and gradually increase the dose to the desired amount. Tools Tools. The use of acarbose but not other AGIs has potential links with hepatitis in some instances. Manahil Akmal ; Roopma Wadhwa. Save for later Page saved! A Cochrane systematic review assessed the effect of AGIs in people with impaired glucose tolerance , impaired fasting blood glucose , elevated glycated hemoglobin A1c HbA1c. GENERAL APPROACH Although alpha-glucosidase inhibitors have been studied as monotherapy for initial treatment of diabetes and as part of a combination regimen, we do not consider them to be usual first-line therapy, because of relatively low efficacy and poor tolerance. 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. The same statistical methodologies were applied separately to incident diabetes and to CV outcomes. They also do not cause hypoglycemia, making them a useful substitute for sulfonylureas, which are associated with frequent occurrences of hypoglycemia. For incident diabetes, a further two small-scale trials were identified but not included. Correspondence to Ruth L. Category : Alpha-glucosidase inhibitors.