Acarbose is a pseudo-tetrasaccharide comprised of cyclo-hexitol, an amino sugar, and two glucose units (Figure 2). It is a potent, reversible inhibitor of the enzymes responsible for carbohydrate digestion and absorption, namely pancreatic alpha-amylase and the alpha-glucosidases. When acarbose is ingested along with a carbohydrate-containing meal, digestion is inhibited and liberation of glucose is delayed. Although acarbose does not interfere with the absorption of available glucose, acarbose reduces the rate of glucose entry into the blood stream and results in a smaller rise in postprandial blood glucose. This is associated with a reduced secretion of insulin and lower postprandial serum insulin levels. As well, acarbose treatment is associated with a reduction in postprandial plasma triglyceride levels.
Because acarbose inhibits the activity of alpha-glucosidases (including sucrase), sucrose or food substances that contain polysaccharides should not be relied on to correct hypoglycemia promptly in acarbose-treated patients. Treatment of hypoglycemia, which may occur in acarbose recipients who are also taking hypoglycemic agents such as sulphonylureas or insulin, requires glucose administration to ensure a response. Also, acarbose possesses no activity against the brush border enzyme lactase and, hence, it does not induce lactose intolerance.
Because acarbose inhibits digestive enzymes in the proximal small intestine, greater amounts of undigested carbohydrate are delivered to the colon. Fermentation of these substances by colonic bacteria produces gas and leads to symptoms of abdominal distension and flatulence, and may cause diarrhea. The severity of adverse gastrointestinal effects increases at higher doses of acarbose and is worse in patients who consume a diet high in refined carbohydrates (ie, sucrose). During continued treatment with acarbose, however, there is a compensatory increase in alpha-glucosidase activity in the more distal portions of the small bowel, which tends to reduce the severity of gastrointestinal intolerance over time. Looking for a great online pharmacy you could trust and where you could find buy cheap alegra at best prices? You have one pharmacy like that already and can finally enjoy the best quality of service ever experienced.
Acarbose does not cause malabsorption of carbohydrate because total bioavailability of carbohydrate calories is not reduced, and acarbose does not cause weight loss in diabetic patients. It does not stimulate insulin secretion nor does it directly affect the insulin resistance commonly present in NIDDM.