Oral antidiabetic medications - Alpha-glucosidase inhibitors: Nursing Pharmacology

Alpha-glucosidase inhibitors are medications primarily used to treat type 2 diabetes mellitus, and have an unlabeled use for type 1 diabetes mellitus as an adjunct to insulin.

Now, type 2 diabetes mellitus is characterized by insulin resistance, which is when tissue cells have trouble responding to insulin to use glucose from the blood, while in type 1 diabetes mellitus, there’s no insulin at all.

As a result, tissue cells starve for energy despite having high blood glucose levels, which is called hyperglycemia.

Now, alpha-glucosidase inhibitors include medications like acarbose and miglitol, which can be taken orally.

Once administered, these medications act in the small intestine, where they inhibit the enzyme alpha-glucosidase, which helps digest complex carbohydrates into simple carbohydrates, such as glucose, that can be absorbed through the lining of the intestine and into the blood.

As a result, alpha-glucosidase inhibitors delay the absorption of ingested carbohydrates, ultimately leading to a smaller rise in blood glucose.

Unfortunately, the undigested carbohydrates remain within the intestines and are digested by intestinal bacteria.

Because of that, clients taking alpha-glucosidase can often present with gastrointestinal side effects, such as abdominal pain, flatulence, and diarrhea. In addition, acarbose may lead to hepatic injury, while clients on miglitol may develop a skin rash.

As far as contraindications go, alpha-glucosidase inhibitors should not be given to clients with gastrointestinal conditions like inflammatory bowel disease, or IBD for short, as well as ileus, colonic ulceration, or intestinal obstruction.