Is acarbose the same as metformin?

Metformin and acarbose are both oral prescriptions used to treat type 2 diabetes, yet they work in various ways. Here is a top to bottom gander at how these two medications are comparative and unique.

What Are the Main Differences Between Acarbose and Metformin?

Metformin and acarbose are both oral prescriptions used to treat type 2 diabetes, yet they have different frameworks of activity and side effect profiles. Acarbose is an alpha-glucosidase inhibitor that delays the absorption of starches from the small intestine, while metformin is a biguanide that diminishes hepatic glucose creation and additions insulin sensitivity(1).

One of the primary distinctions among acarbose and metformin is their mechanism of action. Acarbose straightforwardly follows up on carb assimilation in the gut, while metformin essentially decreases hepatic glucose yield and further develops insulin resistance (2).

Another key contrast is in the timing of administration. Acarbose is taken with the primary bite of a meal, though metformin is taken with meals yet not really at precisely the same time as eating (3).

With respect to side effects, acarbose can cause fart and diarrhea, while metformin is probably going to cause nausea, retching, and stomach trouble (4).

Also, the effect on A1C levels contrasts between the two meds. Acarbose might prompt an modest decrease in A1C, while metformin regularly brings down A1C by 1-2% (5).

Weight management is another area of distinction. Acarbose isn't related with weight reduction or hypoglycemia, though metformin might prompt modest weight reduction and seldom causes hypoglycemia (6).

Furthermore, the approved uses of the two drugs vary. Metformin can be utilized as monotherapy or in combination with other diabetes drugs, while acarbose is just endorsed for use in combination with diet and exercise or other antidiabetic prescriptions (7).

In summary, acarbose and metformin both improve glycemic control but through different mechanisms and with distinct side effect profiles. Acarbose acts locally in the gut, while metformin has broader systemic effects. Understanding these distinctions can assist medical services suppliers with settling on informed choices while choosing the most fitting therapy for people with type 2 diabetes.

 When Would Acarbose Be Prescribed Over Metformin?

Acarbose would be prescribed over metformin in certain situations, including:

- In patients who experience gastrointestinal side effects from metformin like nausea, vomiting, or diarrhea (8). Acarbose may be better tolerated.

- In patients with impaired renal function, as metformin use requires dose adjustment or avoidance in kidney disease (9).

- For type 2 diabetes patients unable to take metformin who need combination therapy with an additional medication (10).

-In patients with prediabetes, as acarbose has been displayed to modestly diminish movement from prediabetes to diabetes, while metformin has not been studied and approved for prediabetes (11).

- For patients with a contraindication to metformin, like cardiovascular breakdown or liver illness, where metformin would be dangerous (12).

- In newly diagnosed patients who prefer trying an alternative to metformin first, as both drugs have pros and cons and patient preferences may dictate choice (13).

-In any case, metformin stays the first-line medication of decision for most patients with type 2 diabetes.Acarbose has a more limited role for patients intolerant of, or needing combination therapy with, metformin.

 What Are the Side Effects of Acarbose?

Acarbose is a medicine usually used to treat type 2 diabetes by dialing back the retention of starches in the body. While it is for the most part all around endured, there are a few potential side effects that clients ought to know about.

The most common side effects of acarbose are gastrointestinal in nature. This is a result of how the prescription functions in the digestive system. Up to 30% of patients might encounter stomach agony, flatulence, and bloating. To minimize these effects, it is recommended to take the medication with the first bite of a meal and to start with lower doses. side effect Over time, this symptom may improve or a dose reduction may be necessary. Now and again, antidiarrheal prescription can assist with dealing with this side effect. Queasiness, vomiting, and acid reflux may likewise happen, yet these are typically transient. If vomiting persists, the use of acarbose should be discontinued. Starting with a low dose and gradually increasing it can improve tolerance.

More uncommon side effects, happening in under 2% of patients, incorporate migraine, wooziness, cough, elevated liver enzymes, skin rash or itching, and muscle throbs or agonies. It is critical to counsel a medical care supplier on the off chance that any of these side effects are capable.

One advantage of acarbose diverged from some other diabetes drugs is that it doesn't cause weight gain or hypoglycemia. Be that as it may, its utilization might be restricted by the pervasiveness of gastrointestinal aftereffects in numerous patients.

All things considered, while acarbose is a strong medication for regulating type 2 diabetes, realizing about its normal optional effects is imperative. By beginning with a low portion, taking it with food, and checking for any serious side effects, patients can work on their resistance to the prescription. Counseling a medical services supplier for direction on overseeing secondary effects is always suggested.

Conclusion

While both acarbose and metformin can be utilized as oral meds for type 2 diabetes, they have various systems of activity, incidental effect profiles, and suitable clinical purposes. Acarbose directly delays carbohydrate digestion and absorption, while metformin reduces hepatic glucose production and improves insulin sensitivity.

Metformin remains the first line medication choice for most patients, while acarbose has a more limited role in those intolerant of metformin or requiring combination treatment. glucose-lowering Proper patient education about expected side effects and dosing recommendations can help improve compliance and treatment success.

References

1. Rena G, Hardie DG, Pearson ER. The mechanisms of action of metformin. Diabetologia. 2017;60(9):1577-1585.

2. Blonde L. Current antihyperglycemic treatment guidelines and algorithms for patients with type 2 diabetes mellitus. Am J Med. 2010;123(3):S12-S18.

3. Bristol-Myers Squibb Company; AstraZeneca Pharmaceuticals. Prescribing information: metformin hydrochloride tablets and metformin hydrochloride extended-release tablets. FDA website. 

4. Bayer Pharmaceuticals. Prescribing information: Precose (acarbose tablets). FDA website. 

5. Van de Laar FA, Lucassen PL, Akkermans RP, Van de Lisdonk EH, Rutten GE, Van Weel C. Alpha-glucosidase inhibitors for patients with type 2 diabetes: results from a Cochrane systematic review and meta-analysis. Diabetes Care. 2005;28(1):154-163.

6. Maruthur NM, Tseng E, Hutfless S, et al. Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: a systematic review and meta-analysis. Ann Intern Med. 2016;164(11):740-751.  

7. American Diabetes Association. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes—2022. Diabetes Care. 2022;45(Suppl 1):S125-S143.

8. McCreight LJ, Bailey CJ, Pearson ER. Metformin and the gastrointestinal tract. Diabetologia. 2016;59(3):426-435.

9. Lalau JD. Lactic acidosis induced by metformin: incidence, management and prevention. Drug Saf. 2010;33(9):727-740.