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Alpha-glucosidase inhibitors

As a class of medicine designed to treat type 2 diabetes, alpha-glucosidase inhibitors work to slow the rate by which sugar is digested after eating. They can be used in conjunction with other medications as well as diet and exercise to keep blood glucose levels within a target range. While alpha-glucosidase inhibitors are appropriate as a first-line therapy for type 2 diabetes, they may not be as effective as other medications such as sulfonylureas or metformin.

Who should use an alpha-glucosidase inhibitor?

While any individual with type 2 diabetes may benefit from an alpha-glucosidase inhibitor, they may be most appropriate for those have been recently diagnosed or who have only slightly elevated blood glucose levels. Medications in this class are also helpful for those who tend to have spikes in blood sugar levels after eating. Individuals using insulin may be able to reduce their level of insulin after starting an alpha-glucosidase inhibitor.

Although generally safe, alpha-glucosidase inhibitors may not be the right choice for those with kidney, liver or heart problems. Women who are pregnant or planning to become pregnant should also talk with their health care provider before starting a treatment regimen that includes an alpha-glucosidase inhibitor.

Medications in the alpha-glucosidase inhibitor class

Alpha-glucosidase inhibitors are available under two brand names:

  • Precose (acarbose)
  • Glyset (miglitol)

Precose was originally approved by the Food and Drug Administration in 1995. Today, patients can purchase either the brand name drug or a generic equivalent. Glyset was approved for use in 1996, and as of this writing, no generic version of the medication is available yet.

Common side effects and dosages

Some individuals may prefer alpha-glucosidase inhibitors since they are unlikely to cause weight gain or unsafe low blood sugar levels. However, this class of medicines is also commonly associated with some unpleasant side effects such as stomach pain, gas and diarrhea. Starting with a low dose may minimize these side effects. Limiting intake of high-carbohydrate foods may also reduce the incidence of these side effects.

To be effective, alpha-glucosidase inhibitors generally must be taken with each meal. The medication comes in tablet form and is typically taken up to three times per day with food.

IMPORTANT: To avoid potential drug interactions and serious side effects, an individual should begin treatment with alpha-glucosidase inhibitors or any other medication only after consulting with a qualified health care provider.

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About Maryalene LaPonsie

As a constituent case manager in the Michigan Legislature, Maryalene LaPonsie spent 13 years helping individuals address concerns regarding Medicaid eligibility, medical insurance claims and government regulations. Today, she reports on a variety of issues including health insurance, health reform and affordable health care options. Maryalene holds a bachelor's degree in political science from Western Michigan University.

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