25.13 : 経口血糖降下剤：α-グルコシダーゼ阻害剤

α-glucosidase inhibitors impede intestinal α-glucosidase enzymes, delaying the digestion of starch and disaccharides. This effectively curtails postprandial glucose spikes.

These agents also stimulate the secretion of the glucoregulatory hormone GLP-1, further aiding glucose reduction.

Significant examples of this drug class include acarbose, and miglitol.

Acarbose is minimally absorbed, while the glucose-mimetic miglitol shows good absorption. Both these drugs are renally eliminated.

These drugs show adverse effects like malabsorption, flatulence, diarrhea, and abdominal cramping. Additionally, acarbose use is linked to mild to moderate hepatic transaminase elevation.

They may also induce hypoglycemia when co-administered with insulin or an insulin secretagogue.

Additionally, acarbose decreases digoxin's absorption, while miglitol decreases the absorption of propranolol and ranitidine.

Despite the potential side effects, these agents are valuable adjuncts to diet and exercise for type 2 diabetes patients.