For people with type 2 diabetes, alpha-glucosidase inhibitors
work in the intestine to reduce glucose absorption.
Alpha-glucosidase inhibitors slow the digestion of carbohydrates
in the small intestine.
These medications work by inhibiting enzymes in the intestine
that break down carbohydrates, so glucose levels rise more
slowly after eating. Prescribed brands are Precose (acarbose)
and Glyset (miglitol).
•
Some people who take these medications experience intestinal
gas, bloating, and diarrhea.
However, these side effects often diminish with continued
use or dosage adjustment.
Newer Medications:
SGLT-2 Inhibitors
•Suppresses
an enzyme that facilitates glucose transport
across renal tubules
•Lowers
“renal threshhold” for urinary glucose excretion
•Facilitates
weight loss, reduction in glycemia
•Does
not cause hypoglycemia
•Once
daily oral medication
|
|
Brand
name |
Generic
name |
|
Invokanna |
canagliflozin |
|
Farxiga |
dapaglifolozin |
|
DPP-4
Inhibitors |
|
Among the newest
diabetes medications are DPP-IV (4) inhibitors. They may be the
perfect example of a “domino effect” in diabetes treatment.
Let’s take a moment to examine how this class of drugs works.
When food passes
through the stomach and enters the small intestine, specific
cells of the intestine produce a substance called
Glucagon-Like-Peptide-1(GLP-1). Once in the circulation, GLP-1
does a number of things:
•It
makes it easier for the pancreas to release its stored-up
insulin, but only in the presence of elevated blood sugar
(so it does not cause hypoglycemia)
•It
decreases glucagon secretion from the pancreas (glucagon is
a hormone that raises blood sugar)
•It
promotes the growth and duplication of cells in the pancreas
that produce insulin
•It
slows the movement of food from the stomach into the
intestines, and
So GLP-1 is very
good for helping to control blood sugar levels. Unfortunately,
GLP-1 only lasts for a few minutes because it is broken down by
an enzyme called DPP-IV. DPP-IV inhibitors are designed to
counter this action and keep DPP-IV from breaking down GLP-1,
allowing GLP-1 to circulate longer and work harder.