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. 2012:5:357-67.
doi: 10.2147/DMSO.S28340. Epub 2012 Oct 12.

Critical evaluation of the role of acarbose in the treatment of diabetes: patient considerations

Christoph Rosak  1 , Gabriele Mertes
Affiliations

Critical evaluation of the role of acarbose in the treatment of diabetes: patient considerations

Christoph Rosak et al. Diabetes Metab Syndr Obes. 2012.

Abstract

The alpha-glucosidase inhibitor acarbose has been used for more than 20 years in the management of hyperglycemia. Owing to its unique mode of action in the gastrointestinal tract, its properties are very different from other antidiabetic medications. Patients on long-term treatment to control a chronic disease are not only interested in good treatment efficacy, but are also even more interested in the safety and side effects of their medications. Significant aspects of acarbose predominantly regarding safety and tolerability in the management of type 2 diabetes and prediabetes are reviewed. It is concluded that acarbose is a convenient long-term treatment option, with benefits for both type 2 diabetics and patients in a prediabetic state.

Keywords: acarbose; patient considerations; prediabetes; side effects; type 2 diabetes.

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Figures

Figure 1
Figure 1
Acarbose mechanism of action: competitive inhibition of the intestinal enzymatic hydrolysis of oligosaccharides. Copyright © 1991. Reprinted with permission Thieme Publishers. Bischoff H. Effect of acarbose on diabetic late complications and risk factors – new animal experimental results. Akt Endokr Stoffw. 1991;12:25–32.
Figure 2
Figure 2
Direct (−) and indirect (---) effects of acarbose on different hormonal, metabolic, and inflammatory variables. Copyright © 2009, Bentham Science Publishers. Adapted from Rosak C, Mertes G. Effects of acarbose on proinsulin and insulin secretion and their potential significance for the intermediary metabolism and cardiovascular system. Curr Diabetes Rev. 2009;5:157–164. Abbreviations: BG, blood glucose; CRP, C-reactive protein; FFA, free fatty acids; FBG, fasting blood glucose; NFκB, nuclear factor kappa B; PP, postprandial; PAI, PAI-1, plasminogen activator inhibitor-1; TG, triglycerides.
Figure 3
Figure 3
Sucrase and maltase content in small intestine under fiber-free or fiber-rich diet with or without addition of acarbose. Data are from Creutzfeldt et al.
See this image and copyright information in PMC

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