Alpha-glucosidase Inhibitors

Brand Name (Generic Name)

Glyset (miglitol)
Precose (acarbose)

What are Alpha-glucosidase Inhibitors?

Alpha-glucosidase inhibitors are a class of oral medications that block the enzymes that digest starches. When that happens the carbohydrates don't turn into sugar quite so fast and therefore the blood sugar rises much slower after the meal. This helps because it gives the pancreas time to put out insulin. These medicines primarily work to lower after meal blood sugar spikes. There are now two alpha-glucosidase inhibitors, acarbose (AK-er-bose) and miglitol (MIG-leh-tall) available in the US.

Who can take them?

Selected adults with type 2 diabetes can take these medicines with their healthcare provider's approval and supervision. They can also be given along with some of the other diabetes medicines to produce a greater effect.

Who should not take these medicines?

You should not take these medicines if you have any problems with your stomach, intestines, or colon that has been diagnosed by your healthcare provider. They should also be used with caution if you have reduced kidney function.

Advantages of these medicines

They are unlikely to cause low blood sugar when used alone.


Some people find that they have problems with intestinal gas and diarrhea and are unable to tolerate these medicines.

What dosage can I take and how should I take it?

The initial dosage for either medicine is 25 mg, 3 times a day. This is adjusted at 4-8 week intervals and can increase to 50 or 100 mg. They are taken orally in tablet form, usually with the first bite of the meal. You may be instructed to start very slowly give your body a chance to get used to the medicine.

What are the common side effects?

• Stomach pain
• Gas and bloating
• Diarrhea
• Elevated liver function tests

Reviewed by James A. Bennett 5/14.

Last Modified Date: May 23, 2014

All content on is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...
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