A diabetes specialist answers your questions. I am Dr. Sun, follow Dr. Sun on sugar to learn more about sugar control.

As a chronic disease, diabetes requires long-term medication. Acarbose, a glucosidase inhibitor commonly used in clinical practice, is one of the most commonly used oral hypoglycemic agents for diabetes and is taken by many patients. However, they are very worried about the side effects, and the most frequently asked question in outpatient clinics is whether taking it regularly is harmful to the body.

Let's talk about the use of acarbose in more detail.

Mechanism of action of acarbose

Acarbose inhibits glycosidase activity in cells of the small intestinal wall, thereby prolonging the degradation of oligosaccharides, disaccharides, and polysaccharides and delaying the absorption of glucose and fructose, which can beReduces postprandial blood glucose and plasma insulin concentrationsThe effects of. Also, acarbose has an effect on the patient's weight, and after treatment the patientSignificant reduction in body mass index. Acarbose alsois the first and only oral hypoglycemic agent approved for use in people with abnormal glucose tolerancesSince 2002, when acarbose was approved in China for the treatment of elevated postprandial glucose in people with abnormal glucose tolerance, acarbose has been approved in more than 30 countries for the treatment of people with abnormal glucose tolerance.

What are the conditions that prohibit the use of acarbose?

Acarbose is contraindicated in the treatment of acarbose and its excipients.be allergicIt is contraindicated in patients with chronic gastrointestinal disorders with significant digestive and absorption disorders, patients suffering fromPatients with severe hernias, intestinal obstruction and intestinal ulcers, severe renal impairment with creatinine clearance less than 25 ml/minuteContraindicated. Asymptomatic elevation of liver enzymes occurs in individual patients, especially with high doses, but the enzymes return to normal after discontinuation of the drug.

What should I be aware of when taking acarbose?

Taking acarbose causes sucrose and glucose to move more slowly, so if acute hypoglycemia occurs, sucrose should not be used but glucose should be used to correct the hypoglycemic response. Acarbose.maternalshall not be used because the effects of acarbose in breast milk on the infant cannot be ruled out.Lactating womenIt should also not be used. This medicine is not to be used forPatients under 18 years of ageHowever, there is no need to change the dose and frequency of the medication in elderly patients over 65 years of age.

What should I do if I have low blood sugar while taking acarbose?

While taking acarbose, sucrose or foods containing sucrose can often cause abdominal discomfort, increased gas or even lead to diarrhea due to increased carbohydrate fermentation in the colon. Acarbose has antihyperglycemic effect, but it does not cause hypoglycemia by itself, but hypoglycemia may occur when it is used with insulinotropic agents, metformin or insulin, so the dosage of the above mentioned medications should be reduced, otherwise hypoglycemic coma may occur.


Read to be rewarded and follow to learn more!

Acarbose is a hypoglycemic drug with a status second only to metformin, and its mechanism of action is simply: delaying the conversion of sugars (including starch) from food into disaccharides in the gastrointestinal tract, and then from disaccharides to monosaccharides, thus reducing postprandial blood glucose production. So.Particularly suitable for those with high postprandial blood glucose and a large proportion of carbohydrates in the diet.. However, taking acarbose can also appear to have certain side effects on the body.

Below, "Ask the Doctor" will introduce the 3 side effects that Acarbose can cause and how to eliminate them.

Side effects of acarbose:

• Gastrointestinal discomfort. Carbohydrates retained in the gastrointestinal tract are fermented by intestinal bacteria and are prone to farting, abdominal pain, diarrhea, and cramping pain in the stomach and intestines.
  
• Taking acarbose may cause hepatic dysfunction, mainly in the form of jaundice and elevated transaminases.
  
• Hypoglycemia may occur in glucose patients on the combination.
  

Five ways to help you dissipate side effects:

1. Start with a small dose, chewed before meals or with the first few bites. Recommended starting dose: 50 mg, or 1 tablet, 3 times a day. When your body tolerates it, increase to 100 mg (2 tablets) 3 times a day;
   
2. Be careful with your diet while taking the medication. Starch (complex sugar) should be eaten more in moderation and sucrose (simple sugar) should be eaten less. Moreover, you should make sure that you have enough carbohydrates (at least 30% or more) at each meal; acarbose will not be able to work as a medicine if you only eat eggs, vegetables, and fats;
   
3. Avoid taking it with some medications that will work in the intestines, such as cholestyramine (calamine) and montelukast;
   
4. If acute hypoglycemia occurs, it cannot be supplemented with sucrose and can only be relieved by oral administration or infusion of glucose;
   
5. Moderate monitoring of liver function during medication. Intervene promptly if abnormalities are detected.
   

There are also many sugar addicts who take it for a while and then their postprandial blood sugar comes down and ask if they can stop taking it.

Here, "Ask the Doctor" suggests:Don't stop taking your medication even if your postprandial glucose is on target. Because acarbose works for a very short period of time, a single dose will only cover one meal. If you don't take the medicine at the next meal, your blood sugar will rise again after the meal.

The above content is edited and organized by "ask the doctor" for you, want to know more authoritative health knowledge, welcome to pay attention to us!

Acarbose is widely used clinically and is effective in controlling blood glucose in type 2 diabetes mellitus, especially postprandial blood glucose. However, long-term application should be careful to monitor the adverse effects of acarbose and interactions with other drugs.

Common adverse reactions to acarbose include adverse digestive reactions, skin and adnexal damage, with more serious adverse reactions being liver damage, intestinal obstruction and lymphocytic colitis.

Acarbose inhibits α-glucosidase, which can slow down the degradation and absorption of polysaccharides, oligosaccharides, or disaccharides into the bloodstream in the intestinal tract, slowing down the absorption of carbohydrates in the intestinal tract to reduce the postprandial glucose increase. Due to the increase of glycolysis in the colon, sucrose or foods containing sucrose can cause nausea, bloating, diarrhea, and abdominal pain, which are common reactions during the first month after the use of acarbose and during the whole course of treatment. adverse reactions, but these symptoms will decrease with longer dosing.

Skin and accessory damage from acarbose include skin allergic reactions, rash, and erythema multiforme.

Hepatic damage from acarbose is characterized by elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltranspeptidase (GGT) in association with drug-induced hepatitis. Lymphocytic colitis and intestinal obstruction have also been reported.

Since type 2 diabetes mellitus is often treated with several different types of oral hypoglycemic agents, and often in combination with other drugs, attention should be paid to the adverse effects caused by drug interactions. For example, the combination of acarbose with other hypoglycemic agents, aspirin, clofibrate, fenfluramine, fluoxetine, monoamine oxidase inhibitors, tricyclic antidepressants, etc., may cause hypoglycemia; the interaction of acarbose with phenothiazines, catecholamine derivatives, diuretics, calcium antagonists, dibenzeneglycolide, and oral contraceptives may lead to a further deterioration of hyperglycemia.

Heart disease has become one of the common complications of diabetes mellitus, therefore, the combination of hypoglycemic drugs and drugs for heart disease is more common in clinical practice. Some reports suggest that acarbose may lead to a decrease in the bioavailability of digoxin or an increase in the bioavailability of warfarin. Therefore, the clinical use of acarbose should emphasize the safety monitoring of adverse reactions and drug interactions.

If this article is helpful to you, welcome to pay attention, ask questions and additions, and communicate together to improve.

References:

[1] Yang Xiaohui, Deng Yuanwang. Progress of the latest foreign studies on the adverse reactions of acarbose Chinese Pharmacovigilance 2009.1(36-40)

Cui Xifeng Beijing Fengtai Hospital 2018.11.16

Drugs.com authoritative interpretation, unauthorized reproduction, plagiarism will be prosecuted

Acarbose is the basic drug used in the treatment of diabetes, mainlyBy delaying the absorption of carbohydrates, postprandial blood glucose is lowered, so acarbose is suitable for patients with high postprandial blood glucoseThe following is a list of the most commonly used drugs in the market. Usually 50mg per session, three times a day; depending on the condition, this can be increased to 200mg per session, three times a day.

Gastrointestinal flatulence is the most common adverse effect of acarbose, with an incidence of more than 10%. Since acarbose delays the absorption of carbohydrates and prolongs the retention of carbohydrates in the gastrointestinal tract, the breakdown of carbohydrates by intestinal bacteria increases, causing intestinal flatulence and discomfort.

Diarrhea, abdominal painIt is the second most common adverse reaction to acarbose after flatulence, occurring in about 1-10% of cases. Diarrhea and abdominal pain are also associated with increased carbohydrate fermentation in the intestine. Swallowing the whole tablet before a meal or chewing it with a meal can effectively minimize the gastrointestinal adverse effects of acarbose.

transferase abnormalityIt is a relatively rare adverse reaction to acarbose, with an incidence of about 0.1-1%. The main manifestation is asymptomatic elevation of aminotransferases, so patients taking acarbose are advised to review their aminotransferases after six months, and there have been occurrences of fulminant hepatitis with acarbose.

Jaundice, edemaIt is a very rare adverse reaction to acarbose with an incidence of less than 0.1%. If a diabetic patient develops yellowing of the skin and sclera after the use of acarbose, hepatic damage may be caused by acarbose, and the drug should be stopped immediately and the cause identified. When edema occurs, the presence of combined cardiac and renal dysfunction should also be ruled out.

It should be noted that acarbose itself does not cause hypoglycemia, but when combined with drugs such as metformin and insulin, hypoglycemia can occur, manifested by palpitations, sweating, dizziness, at this time, it is recommended to take glucose by mouth or sedative push, and can not be taken orally with sucrose, as acarbose delays the decomposition of sucrose, and does not provide rapid relief of hypoglycemic symptoms.

Thanks for reading!

Hello, I am a pharmacist who has been working in a hospital for many years and is a state licensed pharmacist and would be honored to answer your questions.

When it comes to this kind of drug, Acarbose, like Metformin, is the same as the oral hypoglycemic drugs in the first line of drugs. However, the name "Acarbose", after all, is too clinical, if you have not studied medicine, pharmacy or friends with diabetes, it will feel very strange. If you call it something else -artemisia (loanword)Many people will be familiar with it because the name is very common in hospitals and pharmacies.

Before learning more about the damage that Acarbose can do to the human body, it's important to take a brief look at what exactly are the common hypoglycemic medications that are taken orally so that readers can have a longitudinal view of what's going on. As someone who has"Billions."For chronic diseases of this order of magnitudediabetesThere are more than a dozen types of commonly used drugs, the more common ones being the following (Because of space constraints, we will only introduce the names of common hypoglycemic drugs and will not expand on the adverse effects of each drug！):

1. Sulfonylureas

In the evolutionary history of the drug, it is roughly divided into the following three generations, respectively, the first generation of drugs toluene sulfobutylurea, chlorosulfopropylurea; the second generation of drugs glibenclamide, gliclazide; the third generation of drugs glimepiride, etc.

2. Biguanides

This is also a common hypoglycemic drug that we see in the clinic. The clinically used drugs are probably phenelzine and metformin.

3. a-Glucosidase inhibitors

The clinically applied drugs areacarbose (loanword), voglibose, and miglitol. The main reason for the hypoglycemic effect of these medicines is the competitive inhibition of the enzyme a-glucosidase at the small intestine, which reduces the absorption of dextrin starch, disaccharides, and other substances in the small intestine, thus lowering the diabetic patient's postprandial hyperglycemia.

4. Insulin sensitizers

The main types of these drugs used in clinical practice today arethiazolidinedioneDerivatives of rosiglitazone, cycloglitazone, bisiglitazone, and englitazone are the main ones.

5. Non-sulfonylurea insulinotropic agents

The two main drugs that cash has been used in the clinic are repaglinide and nateglinide.

Of course, with the development of science and technology, in recent years, people have a deep understanding of hypoglycemic drugs, many new drugs are also involved in the hospital, because of the space relationship, here will not be expanded!

From the above account we can see thatThe acarbose mentioned in your question is a glucosidase inhibitor.The main reason for this is that it is not a good idea to use it as a treatment for diabetes. It can be said that he is widely used in the clinic for all types of diabetes mellitus, mainly can be used alone in elderly patients or patients with significant postprandial hyperglycemia. It is usually combined with oral hypoglycemic drugs or insulin. As for the side effects, because it is the carbohydrate in the intestinal tract decomposition and absorption of obstacles to the prolongation of the retention of time.As a result, it may lead to an increase in gas production by bacterial fermentation, so certain patients are prone to adverse reactions such as intestinal gas, abdominal pain, diarrhea, etc.. So the way we generally recommend taking it is to swallow rice with acarbose at mealtime, so that the above symptoms can be relieved; and then there are individual cases where some skin allergic reactions such as rashes, hives, etc. may occur, and in severe cases it may even lead to shock, although such cases are extremely rare.

So.This drug, or any hypoglycemic drug for that matter, should ideally be taken under the advice of a physician.Since basically all medicines will affect the patient's liver and kidneys, and since hyperglycemic patients are usually on a lifelong medication regimen, our doctors will take into account the patient's condition, gender, age, the level of glycemic index, and the presence of complications, among other factors, when choosing medicines!Patients should not choose their own medicines and should always do so on the advice of their doctor!

I hope this helps you ^_^

If you like my answer, welcome to follow the headline number: [Mu Ge Night Talk]. I will regularly share some medicine applications and their nutritional and health knowledge, thank you!

Acarbose is a first-line medication in national and international guidelines for diabetes, and reduces postprandial blood glucose primarily by slowing the conversion of carbohydrates (staple foods) to glucose, and ultimately slowing the absorption of glucose from the digestive tract. Unlike insulin, acarbose does not cause hypoglycemia or weight gain when taken long-term.

It is important to note that acarbose alone rarely causes hypoglycemia, but hypoglycemia is possible if used in combination with insulinotropic agents (glargine- and leonine-based hypoglycemic agents) or insulin. In addition, initially taking acarbose may appear gastric bloating, abdominal pain, gastrointestinal cramps, stubborn constipation, increased gas and other digestive symptoms, which is related to the drug in the small intestine stays in too long, by the intestinal bacterial decomposition, and increased gas production, with the prolongation of the time of taking the drug, these symptoms can be relieved. In addition, long-term use of the drug has caused liver function abnormalities (transient elevation of aminotransferases) has been reported, which can be normalized by stopping the drug under the guidance of the doctor, or symptomatic treatment.

If hypoglycemia occurs while taking the medication, glucose water or glucose lozenges need to be given to correct the hypoglycemia. Since acarbose delays the conversion and absorption of carbohydrates, eating carbohydrates such as cookies and buns will not correct the hypoglycemia quickly.

The dietary structure of Chinese people, carbohydrates (staple food) occupies a large proportion, so Acarbose is a very suitable for Chinese diabetic patients dietary habits of an oral hypoglycemic drugs, its main role in the digestive tract, rarely absorbed into the bloodstream, so few interactions with other drugs, the safety of long-term use is good.

References:

Chinese Guidelines for the Prevention and Control of Type 2 Diabetes Mellitus (2013 Edition)

American Diabetes Association: guidelines for the treatment of diabetes (2018)

Acarbose is a commonly used and relatively safe hypoglycemic agent, and we can see from its mechanism of action that its side effects are minimal, mainly gastrointestinal discomfort. Acarbose is a glucosidase inhibitor, inhibiting the activity of glucosidase can slow down the efficiency of polysaccharides into monosaccharides, so that the blood glucose can rise more smoothly, especially suitable for patients with high postprandial blood glucose.

Most diabetic patients tolerate long-term use of acarbose relatively well, and its more common side effects are gastrointestinal discomfort, such as bloating, farting (caused by fermentation of gastrointestinal flora as a result of delayed digestion of food), abdominal pain and diarrhea (intestinal dysfunction), elevated aminotransferases and jaundice due to hepatic impairment (rare), and hypoglycemia (acarbose alone does not lead to hypoglycemia and this adverse effect usually occurs only if it is used in combination with other hypoglycemic medications). (Acarbose alone does not cause hypoglycemia; it is usually combined with other hypoglycemic agents).

Overall, it is safe to take acarbose for a long period of time, you need to be careful to check your liver function regularly (about six months), and if hypoglycemia occurs you need to take glucose to relieve the symptoms (polysaccharides are not as effective). I hope my answer can help you! If you like it, just click a like!

Acarbose belongs to the α-glucosidase inhibitor, which slows down the decomposition of starch and sucrose into glucose by inhibiting the activity of various enzymes such as maltase, glucoamylase, sucrase, etc., and then reduces the efficiency of intestinal glucose absorption, in order to promote the stabilization of postprandial glucose, and to achieve the purpose of lowering blood glucose;

In fact, Acarbose is already considered relatively safe compared to other hypoglycemic drugs. After the drug is taken orally, only 1 to 2% of the active ingredient will be absorbed by the intestines, and the rest will either be broken down by the intestinal bacteria or excreted into the body with the feces;

Although the absorption of drugs is very small, but there is still the possibility of damage to health, such as liver enzyme elevation, the situation is mostly due to the excessive amount of medication, and most of this liver enzyme elevation is not accompanied by symptoms, so it is difficult to detect, and the need for patients to frequently monitor their own liver enzyme changes; Today's headlines - Dr. Zhang, Department of Integrative Medicine

In addition, the most obvious disadvantage of acarbose would be the adverse digestive reactions, especially symptoms such as bloating and diarrhea, because the process of sugar metabolism in the intestines is inhibited by the drug, allowing more sugar to be broken down by intestinal bacteria, which generates large amounts of gas to the point of significant abdominal discomfort!

Acarbose Contraindications:

1、It is prohibited for those who are allergic to acarbose;

2、Pregnant and lactating women are prohibited;

3. Prohibited for patients under 18 years of age;

4, chronic gastrointestinal dysfunction and intestinal obstruction, intestinal ulcers are prohibited;

5, suffering from Roemheld syndrome or severe hernia should be prohibited;

6, Creatinine clearance <25ml/min renal impairment is prohibited!

What are the health risks of taking acarbose for a long time?

Acarbose is a hypoglycemic drug, second only to metformin in clinical treatment, is a commonly used oral hypoglycemic drug for diabetic patients, and is mainly used to lower the patient's postprandial blood glucose.

The hypoglycemic effect of Acarbose is mainly through the inhibition of gastrointestinal α-glucosidase to break down carbohydrates into monosaccharides, thus delaying the conversion of sugar in food in the stomach, slowing down the rate of absorption of food, and avoiding a significant rise in postprandial blood glucose, so it is particularly suitable for postprandial blood glucose, love to eat carbohydrates for sugar lovers.

However, acarbose is not without side effects, and the main adverse effects of acarbose are described below.

1. Gastrointestinal reactions

Acarbose lowers blood sugar by inhibiting the breakdown of food, which leads to an increase in carbohydrates and other carbohydrates in the gastrointestinal tract and enhanced fermentation, causing patients to fart, abdominal pain, diarrhea and other symptoms, especially after taking the drug to consume a large amount of carbohydrates, the adverse effects increased significantly. Therefore, it is recommended that during the use of Baytril for blood sugar control, patients should strictly adhere to the diabetic dietary choices and avoid excessive intake of carbohydrate-containing foods and beverages.

2. Impairment of liver function

Taking acarbose may have a transient liver function impairment (about one in a thousand to one in a hundred patients), but the impairment is relatively mild, some patients may show symptoms such as jaundice, elevated transaminases, etc. Therefore, it is recommended that during the administration of acarbose, liver function needs to be rechecked once every six months to one year or so, and if liver enzymes are elevated by >3 times, the medication needs to be adjusted under the guidance of a doctor.

3. Hypoglycemic reactions

Acarbose alone does not cause hypoglycemia to occur, when combined with metformin or insulin, hypoglycemia may occur. Therefore, care needs to be taken during co-administration and glucose needs to be replenished as soon as a hypoglycemic reaction occurs.

Summary: Acarbose is a commonly used oral hypoglycemic drug for obese type 2 diabetic patients, especially those with significant postprandial glucose elevation, suitable for long-term use. And the overall safety of acarbose is relatively high, adverse reactions are few and mild, the use of patients do not have to worry too much, only the gastrointestinal reaction may be more obvious (this effect can also play a role in helping patients to control the role of diet, so as to play the effect of weight loss), if you really can not tolerate the adverse effects of acarbose, you can communicate with the doctor to adjust the treatment program.

I am Pharmacist Wang, insisting on spreading the knowledge of cardiovascular and cerebrovascular diseases with simple and easy-to-understand words, and dedicating my own small efforts for a healthy China. If you think my answer is helpful to you, please leave a like! In addition, if you still have questions related to the side effects of acarbose, welcome to leave a message, we discuss together!

As the three major nutrients of sugar for the human body has a relatively important position, but also one of the main sources of energy, under normal circumstances, the body's regulatory system can control the blood sugar to maintain at a normal level, the human body has a lot of elevated blood sugar hormones, including glucagon, adrenaline, glucocorticoids, growth hormone, etc., but the human body is the only glucose-lowering hormone, that is, the big-name insulin.

Insulin not only has a hypoglycemic effect, but also enables the body to better utilize glucose, and also promotes the synthesis of glycogen, fat and protein. The reason why many people get diabetes is that either there is an absolute lack of insulin in the body, or the insulin receptors are no longer sensitive to insulin, and in these cases the body is unable to maintain normal blood glucose, and so the person gets diabetes. Today I'm here to share my knowledge about Acarbose, and by doing so, I'm going to give you a lot of insight and knowledge about this medication as well.

1. What is the glucose-lowering mechanism of acarbose?

In fact, the treatment of diabetes drugs can be broadly divided into several categories, one can promote the secretion of insulin from pancreatic islet cells, which includes sulfonylureas and glinides, representative drugs include glipizide, glibenclamide, repaglinide, and nateglinide; there is also a class of inhibition of glucose decomposition, which mainly includes biguanide, representing the drug is the familiar metformin; and a class of increasing insulin receptor sensitivity to insulin, mainly thiazolidinediones, pioglitazone. Insulin sensitivity, mainly thiazolidinediones, representative drugs include rosiglitazone, pioglitazone.

There is also a class is to introduce today's acarbose, it belongs to the α-glucosidase inhibitors, the main mechanism of action is the role of the small intestinal mucosa brush edge of the glucosidase enzyme, this enzyme's role is to help the human body to quickly absorb the sugars in the food, if the inhibition of this enzyme, then you can slow down the absorption of carbohydrates from the intestinal tract, so as to play a role in reducing postprandial blood glucose.

The trade name of Acarbose is Byzapine, and Acarbose is its generic name, which is equivalent to a person with several names. Acarbose is mainly used for diabetic patients whose fasting blood glucose is basically normal and postprandial blood glucose is significantly elevated, and can be used to lower blood glucose alone or in combination with other hypoglycemic drugs.

2. What are the health risks of taking acarbose for a long time?

In fact, this question itself has some problems, because taking drugs in accordance with the instructions, it can be said that the harm to the human body is minimal. After all, as a drug, the main role is to be used to cure the disease, the results of which the disease is not cured the drug itself but there is some harm to people, this is not picking up sesame seeds lost watermelon?

From an objective point of view, Acarbose is a relatively safe hypoglycemic drug, the most common adverse reaction to long-term use of this clock is gastrointestinal reaction, some patients may experience abdominal pain, bloating, nausea, vomiting, diarrhea and other gastrointestinal symptoms after taking Acarbose. However, this adverse reaction can be alleviated by reducing the dose of the drug, and if the digestive symptoms are obvious, the drug can also be temporarily discontinued.

Acarbose also has a common adverse reaction is liver and kidney function damage, individuals taking acarbose may appear jaundice, if the value of aminotransferase more than two times the normal value or creatinine clearance rate is less than 25ml/min, is required to stop the drug. There is also a part of the people who ate acarbose, appeared to have an allergic reaction, manifested as local skin itching, redness and swelling, once found to be allergic to acarbose can not be eaten, otherwise it may be due to allergy caused by edema of the larynx and suffocation. For pregnant women, children, lactating women can not eat acarbose, because it may cause some harm to them, take pregnant women as an example, acarbose may pass through the placenta into the body of the fetus, thus affecting the growth and development of the fetus.

Purely hand-typed, it is not easy, if you feel that the writing can also be rewarded a praise, point a concern, if you have any questions can be left below ......