Acarbose: An alpha-glucosidase inhibitor for the management of noninsulin-dependent diabetes mellitus
Acarbose is a potent, reversible inhibitor of carbohydrate digestion. It delays liberation of glucose in the gut, reduces postprandial plasma glucose and insulin levels, and produces a modest improvement in overall glycemic control. Acarbose is not appreciably absorbed and the risk of serious systemic toxicity is low. Dose-related gastrointestinal intolerance is frequent initially; however, it diminishes during treatment. Acarbose has no direct effect on insulin secretion or insulin action, and is not associated with changes in body weight. Acarbose is licensed in Canada for the treatment of noninsulin-dependent diabetes mellitus (NIDDM) not adequately controlled with diet and activity. Its unique mechanism of action and low systemic toxicity make acarbose a welcome alternative to existing antidiabetic agents. The potential for acarbose to be used in combination with a sulphonylurea, biguanide or insulin should facilitate greater efforts to improve glycemic control in NIDDM.