type-2 diabetes

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

•It decreases appetite.

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.