Diabetes is an “undead cancer” that cannot live without glucose-lowering drugs, and complications are likely to arise once sugar control fails. What takes away the life of a diabetic is not diabetes itself, but the complications caused by diabetes, so the usual sugar control work must be done. Diabetic patients are inseparable from two kinds of hypoglycemic drugs, they are metformin and acarbose, which are two very good oral hypoglycemic drugs, many people want to understand clearly what is the difference between these two kinds of drugs? Which one is better? Today we will lift this doubt for you. First, the mechanism of action is different, the main difference between acarbose and metformin is the mechanism of action is different. The mechanism of action of metformin is to inhibit the absorption of intestinal glucose and promote the uptake and use of glucose in peripheral tissues, so as to reduce blood sugar, it has no adverse effects on normal blood sugar. Metformin is the preferred oral hypoglycemic agent for diabetic patients and the first-line oral hypoglycemic agent. Acarbose is an alpha-glucosidase inhibitor, its mechanism of action is to control postprandial blood sugar by competing with carbohydrates in the small intestine for an enzyme (glycoside hydrolase) that can hydrolyze carbohydrates, so that the rate at which carbohydrates are hydrolyzed to produce glucose is delayed. Second, the applicable population is different, metformin is particularly suitable for obesity and diabetic patients with ineffective dietary control alone. And acarbose is mainly used for post-prandial blood glucose rise faster diabetic patients. Third, different adverse reactions, metformin may cause lactic acidemia, ketonemia and other adverse reactions, especially in patients with liver and kidney insufficiency, must be used with caution. The most common adverse reactions of acarbose are gastrointestinal reactions. For example, bloating, diarrhea, and gastrointestinal flatulence occur. Therefore, starting with a small dose and gradually increasing to a suitable dose can reduce the occurrence of gastrointestinal adverse reactions. These three points are the most obvious differences between acarbose and metformin.