China
Africa
Explore chapters and articles related to this topic
Allopathic Medicines
Published in Varma H. Rambaran, Nalini K. Singh, Alternative Medicines for Diabetes Management, 2023
Varma H. Rambaran, Nalini K. Singh
Alpha-glucosidase inhibitors (AGIs), such as acarbose (Glucobay) (Figure 2.9a), miglitol (Figure 2.9b), and voglibose (Figure 2.9c), form a new class of “suppressing-based” therapy that target the enzyme, α-glucosidase (AG). AG is an exo-type carbohydrase that is responsible for breaking down complex carbohydrates to glucose in the upper gastrointestinal tract (Kumar, Narwal et al. 2011, Lebovitz 1998). As such, the inhibition of the AG enzyme results in a decrease in complex carbohydrate catabolism, which as a consequence, retards the rise in postprandial BG levels (Lebovitz 1998).Structural formulae of α-glucosidase inhibitors: (a) acarbose, (b) miglitol, and (c) voglibose.
The Metabolic Medicine Postoperative Bariatric Surgery Consultation
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
In contrast, a particularly useful class of antidiabetic meds for the immediate postop bariatric patients are the DPP-IV inhibitors (sitagliptin, saxagliptin, alogiptin, etc.) These have proven to be helpful for patients who require glucose control after discharge but prefer not to take insulin. Another option might include either bromocriptine or alpha glucosidase inhibitors (acarbose, miglitol). However, we have limited experience with them in this setting.
Anti-Diabetic Drugs
Published in Awanish Kumar, Ashwini Kumar, Diabetes, 2020
Alpha-glucosidase inhibitors (AGIs) are another class of anti-diabetic drugs that are considered comparatively safe. This class include drugs such as Acarbose, Miglitol and Voglibose. AGIs, as the name suggests, inhibit the alpha-glucosidase enzyme at the brush border of the small intestines, thus reducing the absorption of carbohydrates from the gut. This results in a decrease in blood glucose level. The major positive aspect is that these drugs do not cause hypoglycaemia, but major adverse effects include abdominal pain, flatulence and bloating. AGIs are very effective in decreasing the post-prandial glucose level and also the glycated haemoglobin (HbA1c) level. Other positive effects of AGIs include decreased lipid levels, improved GLUT-4-based glucose uptake and GLP-1 stimulation that in turn improves insulin sensitivity and action [1,4].
Careful use to minimize adverse events of oral antidiabetic medications in the elderly
Published in Expert Opinion on Pharmacotherapy, 2021
Alpha-glucosidase inhibitors reduce postprandial hyperglycemia and have a moderate effect on fasting plasma glucose levels, resulting in a significant but only moderate reduction in HbA1c levels. Both acarbose [58] and miglitol [59] are generally well tolerated and safe in the elderly. One major advantage of alpha-glucosidase inhibitors in comparison with insulin-secretagogues is the absence of hypoglycemia. As alpha-glucosidase inhibitors reduce postprandial hyperglycemia and may reduce the risk of delayed hypoglycemia, these agents may contribute to dampen the overall glycemic variability. They are considered as a useful and relatively safe therapeutic option in elderly patients with T2D [60]. As in younger individuals, most discontinuations after initiation of alpha-glucosidase inhibitors were due to gastrointestinal side effects such as flatulence and diarrhea. Of note, however, a few case reports of paralytic ileus were reported between 1996 and 2006, all in Japan, in elderly (but also in middle-aged) diabetic patients treated with acarbose and voglibose [61]. Despite the potential advantages of alpha-glucosidase inhibitors in elderly patients with T2D, there is a lack of studies focusing specifically on that population and no studies with hard clinical outcomes that demonstrated a protection against diabetic complications.
Beneficial effects of rutin in diabetes-induced deficits in acquisition learning, retention memory and pain perception in rats
Published in Nutritional Neuroscience, 2020
Parisa Hasanein, Abbasali Emamjomeh, Nasibeh Chenarani, Mussa Bohlooli
Hyperglycemia as the hallmark of diabetes is the main possible candidate in pathophysiology of diabetes and its complications.3,8 For example, hyperglycemia is a causative factor in protein glycation, the post-translational changes in protein structures and functions, which underlie pathological sequelae of diabetes.7,46 Search for efficient inhibitors of glycation is therefore of considerable importance.47 It has been reported that RUT inhibits glycation of bovine serum albumin (90 μM) incubated in an in vitro system.46 Furthermore, RUT administration (50 and 100 mg/kg) orally for 3 weeks could significantly reduce glycosylated hemoglobin in a type 2 diabetic model.7 Another possible mechanism in the hypoglycemic effect of RUT may be related to its role as a α-glucosidase inhibitor which targets α-glucosidase in the small intestine, an intestinal enzyme that catabolizes non-absorbable complex carbohydrates into absorbable monosaccharides. Alpha-glucosidase inhibitors, such as acarbose, are commonly used oral hypoglycemic agents which block the degradation of carbohydrates and delay the absorption of glucose and fructose in the upper small intestine.47,48 The results of a recent computational study using docking technique showed that RUT interacted with four amino acids residues (His 239, His 279, Glu 304, and Pro 309) in the enzyme α-glucosidase, changing its potential binding mode at molecular level in the catalytic site and therefore inhibiting its activity.15
An update on therapies for the treatment of diabetes-induced osteoporosis
Published in Expert Opinion on Biological Therapy, 2019
Sahar Mohsin, May MYH Baniyas, Reem SMH AlDarmaki, Kornélia Tekes, Huba Kalász, Ernest A. Adeghate
This group of oral anti-diabetic drugs, which includes, acarbose, miglitol and voglibose, prevents the conversion of ingested carbohydrate to monosaccharide by competitive inhibition of alpha glucosidase enzymes resident in the brush border of enteric cells of the gut [95]. It thus reduces hyperglycemia by preventive absorption of glucose into the circulation. In addition, alpha glucosidase inhibitors have been shown to stimulate GLP-1 release from the L-cells of the gut [96]. Either the beneficial or harmful effect of alpha glucosidase inhibitors, voglibose, on bone health has not been clearly documented [97]. In a large, nationwide study involving more than 2.89 million patients using anti-diabetic drugs, no major risks was attributed to patients taking alpha glucosidase inhibitors [98]. The side effects of voglibose on bone health have not been documented [99] (Table 5).