1. How Do Alpha-Glucosidase Inhibitors Work?
Alpha-glucosidase inhibitors, which can benefit people with either type 1 or type 2 diabetes,
work by reducing the amount of glucose that the intestines absorb from food. This prevents the
sharp rise in blood sugar levels that people with diabetes typically experience after meals. One
medication in this class, acarbose, may also help increase the body's insulin sensitivity, further
helping to reduce blood sugar levels.
Alpha-glucosidase inhibitors are typically taken three times daily with meals. These inhibitors
have been approved to treat diabetes in the United States since 1995. Two alpha-glucosidase
inhibitors are currently available in the United States: Precose (acarbose) and Glyset (miglitol).
What Alpha-Glucosidase Inhibitors Do Not Do
Alpha-glucosidase inhibitors do not directly lower blood sugar levels or stimulate the pancreas to
produce more insulin. Although alpha-glucosidase inhibitors can be beneficial for patients with
type 1 diabetes, they do not replace insulin for the treatment for this type of diabetes.
Who Should Not Use Alpha-Glucosidase Inhibitors
Patients with gastrointestinal disease (such as inflammatory bowel disease, Crohn's disease,
colitis, celiac disease) should not use alpha-glucosidase inhibitors. These conditions may alter
intestinal absorption, which could affect the way that alpha-glucosidase inhibitors work. Patients
with severe kidney disease also should avoid using alpha-glucosidase inhibitors.
Side Effects and Risks of Alpha-Glucosidase Inhibitors
The main side effect experienced by people using alpha-glucosidase inhibitors is flatulence (gas).
This effect seems to occur more often with higher doses, but can be controlled by slowly
increasing the dose of the drug over time. The other common side effect is diarrhea. Neither
effect is dangerous, but they can be a nuisance and cause some people to stop taking the
medication.
Some people experience abnormal liver function tests when taking alpha-glucosidase inhibitors.
People who are taking another oral anti-diabetic medication may be more prone to low blood
sugar (hypoglycemia) when taking alpha-glucosidase inhibitors. These people should be careful
to watch for the symptoms of hypoglycemia, which include shakiness, sweating, nausea,
lightheadedness and altered consciousness.
"Off-Label" Uses of Alpha-Glucosidase Inhibitors
Alpha-glucosidase inhibitors may have some effects on lowering cholesterol levels in the blood.
There are no other "off-label" uses for alpha-glucosidase inhibitors.

2. Alpha-Glucosidase Inhibitors and Other Drugs
As with any medication, alpha-glucosidase inhibitors may interact with other medications and
supplements. Be sure to tell healthcare providers about any other prescription or over-the-counter
medications, herbs or other supplements being used before starting alpha-glucosidase inhibitors.
Also keep healthcare providers informed before taking any new medications.
Sources:
McCulloch, DavidK. Alpha-Glucosidase Inhibitors andLipase Inhibitors for Treatment of Diabetes Mellitus. UpToDate.com. 2007. UpToDate.
7 Sept. 2007 (subscription).
LifeWire, a part of The New York Times Company, provides original and syndicated online
lifestyle content. Heather M. Ross, MS, APRN, NP, is an adult nurse practitioner specializing in
cardiovascular care. She is a widely published author and lecturer in the fields of cardiac
electrophysiology and heart failure. Ms. Ross lives in Paradise Valley, Ariz.
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