14.01.5 Acarbose

Carbohydrates are broken down to glucose in the gut by the enzyme α-glucosidase, and the glucose is absorbed.   Acarbose is an inhibitor of α-glucosidase, thereby inhibiting the formation of glucose in the gut.  Acarbose is active after oral administration, and is used in the treatment of Type 2 diabetes only.  By inhibiting the formation of glucose in the gut, acarbose leads to reduced absorption of glucose.  Hopefully, the levels of glucose will be reduced to a level that can be handled by the remaining insulin.  The use of acarbose produces extra carbohydrates in the faeces, which leads to flatulence and diarrhoea.  Acarbose has a different mechanism of action to metformin, which means it can be used with metformin to have an additive effect on plasma glucose levels.