Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Expert Opin Pharmacother. 2019 Dec;20(18):2229-2235. doi: 10.1080/14656566.2019.1672660. Epub 2019 Oct 8.
: Alpha-glucosidase inhibitors (AGIs) - oral antihyperglycemic drugs, inhibit upper gastrointestinal enzymes that break down complex carbohydrates into glucose. As a result, the absorption of glucose is delayed, postprandial glucose reduced, and glycemic control improved.: In this review, the authors describe the current recommendations on the use of the three major approved AGIs (acarbose, miglitol, voglibose). Efficacy and safety parameters together with ethnic considerations have been highlighted throughout the manuscript. The article also discusses potential diabetes prevention and cardiovascular effects of these medications.: The overall safety and efficacy of this class of drug appears to be high: AGIs do not increase the risk of hypoglycemia, do not cause weight gain; they also significantly improve postprandial hyperglycemia, have been associated with the reduction in risk factors for cardiovascular disease and may also delay the progression of prediabetes to T2DM. In general, we continue to believe that acarbose, miglitol, and voglibose should be used as third-line add on treatment options to other anti-hyperglycemic agents. However, this class can have earlier consideration in elderly and/or when metformin is contraindicated.
α-葡萄糖苷酶抑制剂（AGI）——口服抗高血糖药物，可抑制上消化道将碳水化合物分解成葡萄糖的酶。结果，葡萄糖的吸收被延迟，餐后血糖降低，血糖控制得到改善。在这篇综述中，作者描述了目前关于使用三种主要批准的 AGI（阿卡波糖、米格列醇、伏格列波糖）的建议。整篇文章强调了疗效和安全性参数以及种族因素。本文还讨论了这些药物在预防糖尿病和心血管方面的潜在作用。这类药物的总体安全性和疗效似乎很高：AGI 不会增加低血糖的风险，不会导致体重增加；它们还显著改善餐后高血糖，与降低心血管疾病的风险因素有关，并且可能还会延缓前驱糖尿病向 T2DM 的进展。总的来说，我们仍然认为阿卡波糖、米格列醇和伏格列波糖应作为其他抗高血糖药物的三线附加治疗选择。然而，当二甲双胍禁忌时，该类药物可以更早地考虑用于老年患者和/或。
