Acarbose for blood glucose control

  At present, China has become the world’s second largest diabetic country after India, and the situation of diabetes in China is not only very serious, but also the control of diabetes is not optimistic. Diabetes cannot be completely cured at present, but can only be controlled by diet, exercise and medication. There are many types of drugs for the treatment of diabetes, but the mechanism of action of different types of drugs is different.   The absorption of starch, dextrin and disaccharides (such as sucrose) in food requires α-glucosidase at the brush border of small intestinal mucosa. α-glucosidase inhibitors can delay carbohydrate absorption and reduce postprandial hyperglycemia by inhibiting α-glucosidase (such as maltase, amylase and sucrase) on the surface of small intestinal mucosa epithelium. 1) Acarbose (such as Bactrim, Carboplatin): mainly inhibits α-amylase, 50-100mg per time, 3 times a day; 2) Voglibose (such as Bexin): mainly inhibits maltase and sucrase, O.2mg per time, 3 times a day. These two preparations are taken in a special way, and the drugs can only be chewed at the same time as the first meal to play a better therapeutic role. α-glucosidase inhibitors can be used as the first-line drugs for patients with type 2 diabetes, especially for those with normal fasting blood glucose (or not too high) but significantly elevated postprandial blood glucose, and can be used alone or in combination with other hypoglycemic drugs; patients with type 1 diabetes are treated with insulin on top of Alpha-glucosidase inhibitors can help to reduce postprandial hyperglycemia. These drugs alone do not cause hypoglycemia, but if combined with sulfonylureas or insulin, hypoglycemia can still occur, and once it occurs, glucose should be given directly orally or intravenously, and eating disaccharides or starchy foods is not effective. These drugs have little intestinal absorption, usually no systemic toxic reactions, common adverse reactions are gastrointestinal reactions such as abdominal distension, increased exhaustion or diarrhea; should not be used for people with gastrointestinal disorders, pregnant women, lactating women and children; but should still be used with caution for people with hepatic and renal insufficiency.  Since our residents mainly eat rice as the main food, in which the main component is carbohydrate, α-glucosidase inhibitors are a class of hypoglycemic drugs very suitable for Chinese people to take. The medication for diabetic patients needs to be reasonably adjusted according to the mechanism of drug action and the patient’s reaction to the drug, which can not only improve the efficacy but also avoid toxic side effects and adverse reactions.