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Acarbose is an oligosaccharide, whereas miglitol resembles a monosaccharide. Miglitol is fairly well absorbed by the body, as opposed to acarbose. Moreover, acarbose inhibits pancreatic alpha-amylase in addition to alpha-glucosidase, and is degraded by gut bacterial maltogenic alpha-amylase and cyclomaltodextrinase. [4] [5]
Acarbose [1] [2] is an anti-diabetic drug used to treat diabetes mellitus type 2 and, in some countries, prediabetes. It is a generic sold in Europe and China as Glucobay ( Bayer AG ), in North America as Precose ( Bayer Pharmaceuticals ), and in Canada as Prandase ( Bayer AG ).
Miglitol is an oral alpha-glucosidase inhibitor used in the treatment of type 2 diabetes. It works by reversibly inhibiting alpha-glucosidase enzymes in the small intestine, which delays the digestion of complex carbohydrates and subsequently reduces postprandial glucose levels. [ 1 ]
This inhibition lowers the rate of glucose absorption through delayed carbohydrate digestion and extended digestion time. Acarbose may be able to prevent the development of diabetic symptoms. [20] Hence, α-glucosidase inhibitors (like acarbose) are used as anti-diabetic drugs in combination with other anti-diabetic drugs.
Alpha glucosidase inhibitors delay glucose absorption at the intestine level and thereby prevent sudden surge of glucose after a meal. [ 2 ] There are three major drugs which belong to this class, acarbose , miglitol and voglibose, [ 2 ] of which voglibose is the newest.
Alpha-glucosidase inhibitors (acarbose, miglitol, voglibose) Inhibit carbohydrate digestion in the small intestine by inhibiting enzymes that break down polysaccharides Slightly lower risk of hypoglycemia compared to sulfonylureas; Associated with modest weight loss; Decreases triglycerides; No detrimental effect on cholesterol
In pharmacology, bioavailability is a subcategory of absorption and is the fraction (%) of an administered drug that reaches the systemic circulation. [1]By definition, when a medication is administered intravenously, its bioavailability is 100%.
A 2020 Cochrane systematic review did not find enough evidence of reduction of all-cause mortality, serious adverse events, cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke or end-stage renal disease when comparing metformin monotherapy to meglitinide for the treatment of type 2 diabetes.