Medicine & USMLE

Alpha-Glucosidase Inhibitors

Diabetes Drugs (New)
  1. DPP-4 Inhibitors
  2. GLP-1 Analogs
  3. Pramlintide (Amylin Analogs)
  4. SGLT2 Inhibitors
  5. Metformin (Biguanides)
  6. Insulin Preparations
  7. Alpha-Glucosidase Inhibitors


Coming soon...

Key Points

  • Alpha (α)-glucosidase inhibitors
    • Drug Names
      • Acarbose
      • Miglitol
    • Mechanism
      • Inhibit alpha (α)-glucosidases at intestinal brush-border
        • Decreased carbohydrate hydrolysis (breakdown)
          • Prevents breakdown of disaccharides into simple sugars that can be absorbed by the intestines
        • Decreased intestinal absorption of glucose
          • Decreased postprandial hyperglycemia
    • Clinical Use
      • Treats diabetes mellitus
        • Typically used with refractory type 2 diabetes mellitus
    • Side Effects
      • Flatulence and Diarrhea
        • Flatulence, bloating, diarrhea caused by the fermentation of unabsorbed carbohydrates
      • Use with Caution in Renal Insufficiency (not recommended)
        • Especially with Miglitol, since miglitol is absorbed systemically and excreted unchanged in the urine. Poor kidney function can therefore lead to increased doses and side effects
        • Acarbose is metabolized nearly completely within the gastrointestinal tract, so very little is excreted in the urine.
      • Weight neutral
        • No effect on weight
      • Does not cause hypoglycemia
        • Since this drug does not cause insulin release, the risk of hypoglycemia is low when used in isolation
        • This drug may slightly increase the risk of hypoglycemia when it is taken together with insulin or insulin-releasing drugs