Diabetes Mellitus:  Lipids

 

Introduction

Acarbose (Precose) and miglitol (Glycet) are the currently available  a-glucosidase inhibitor class of oral anti-hyperglycemic agents.  In general, these drugs lower glucose levels without risk for weight gain or hypoglycemia.  Unfortunately, these drugs have gastrointestinal side effects that often limit their acceptance.

Mechanism of Action

a-Glucosidase inhibitors are competitive, reversible inhibitors of pancreatic a-amylase and membrane-bound intestinal a-glucosidase hydrolase enzymes.  Use of these drugs leads to blocking the enzymatic degradation of complex carbohydrates in the small intestine.  Thus, less carbohydrate is absorbed and the carbohydrate that is absorbed is delayed.    Acarbose binding affinity for the a-glucosidase enzymes is: glycoamylase > sucrase > maltase > dextranase  and has no affinity for the b-glucosidase enzymes, such as lactase.  Miglitol is a more potent inhibitor of sucrase and maltase that acarbose, has no effect on a-amylase.

Section  Details:

Introduction
Mechanism of Action
Efficacy
Side Effects
Dosing

Required Screens:  4
Optional Screens:   4