This article discusses how AGIs work, their side effects, and warnings to be aware of.
What Are Alpha-Glucosidase Inhibitors?
AGIs are drugs used to manage blood sugar spikes following a meal. There are two types available:
Acarbose, under the brand name Precose or PrandaseMiglitol, under the brand name Glyset
How They Work
AGIs decrease the action of enzymes known as alpha-glucosidases. These enzymes break down carbohydrates within the digestive system and convert them into glucose (sugar) for energy. When the enzyme is blocked from doing its job, fewer carbohydrates are turned into sugar.
If a person deals with blood sugar spikes following a meal, AGIs can slow the conversion of carbohydrates into glucose, which limits the amount of glucose that gets into the bloodstream.
Dosage
The AGI dosage differs depending on the type taken. Miglitol is typically started at a low dose of 25 milligrams (mg) three times per day and gradually increased to 50 or 100 mg three times daily. Sometimes, a person may start with a once-daily dose of 25 mg to avoid harsh side effects. These medications must be taken with food, preferably at the very first bite of a meal.
Acarbose has the same dosing of 25, 50, or 100 mg but is slightly different from Miglitol because weight affects how much a person should take. People of all weights will begin with either 25 mg once a day or thrice a day and gradually increase. However, if a person weighs under 132 pounds, they can only take a maximum of 50 mg three times per day. If they weigh over that amount, they can take as much as 100 mg three times daily.
Side Effects
AGIs come with several side effects, some of which are mild and others more severe. Some common and mild side effects include:
Flatulence Bloating Abdominal discomfort Diarrhea Skin rash or hives
Monitoring
While taking AGIs, monitoring blood sugar levels is important because the medication can cause excessively low blood sugar (hypoglycemia) in people that take them alongside other diabetes drugs.
Symptoms of hypoglycemia include:
Shakiness Dizziness Lightheadedness Nervousness or irritability Changes in mood or behavior Headaches Tingling or numbness around the mouth Pale skin Weakness Hunger Jerky or clumsy movements Confusion Seizures Loss of consciousness
Your blood sugar level is low if it falls below 70 milligrams per deciliter (mg/dL). However, that doesn’t mean you must rush to the emergency room.
If you notice your level is low, you can try to raise it by eating 15 grams of carbs to see if it reaches your target range. If that doesn’t work and you notice your blood sugar level continually dropping, it indicates that you are on your way to dangerously low blood sugar levels.
Contraindications and Warnings
There are some health risks associated with the use of AGIS. They include:
Lose consciousnessAre displaying signs of confusionHave a seizureAnytime they may be worried about severely low blood sugar
GI disease: People who have inflammatory bowel disease, colonic ulceration, an increased risk for bowel obstruction, or a disorder that hinders digestion should avoid this medication. Liver problems: In some cases, AGIs can cause an issue with how the liver functions leading to jaundice (yellowing of the skin or eyes) or hepatitis. People with cirrhosis of the liver or other liver diseases should not take AGIs. Chronic kidney disease: Although some research has found that people with chronic kidney disease can take AGIs, tell your healthcare provider if you have kidney issues before starting this medication.
Summary
AGIs are medications used as additional therapy for people with diabetes. They are designed to help lessen blood sugar spikes following a meal by reducing how many carbs are broken down into sugar in the body. While the drug is safe and can help people manage their blood sugar effectively, it has some side effects. They are usually mild and can include diarrhea, bloating, and flatulence. Typically, these side effects disappear within a few weeks of starting treatment.
People taking AGIs must monitor their blood sugar levels regularly to ensure they do not develop dangerously low blood sugar due to a lack of carb absorption. By doing so, they can avoid severe health repercussions. Those with GI or liver disease should avoid treatment with AGIs.
A Word From Verywell
Having diabetes isn’t always easy, but many medications are available to help you manage your blood sugar levels. If you notice your blood sugar always spikes after a meal, speak to your healthcare provider about AGIs. While they are not appropriate for everyone, they could be a supplemental treatment option to help keep your after-meal spikes at bay.
