Klaudia Stocerz

Alpha-glucosidase inhibitors as an element of type 2 diabetes treatment

 

2025-12-30

Research subject. Acarbose, voglibose, and miglitol are α-glucosidase inhibitors that exhibit a similar mechanism of action, delaying the enzymatic breakdown of carbohydrates in the small intestine. This review discusses the basic structural properties of each compound, their mechanism of action, and key aspects of pharmacokinetics. Data on clinical efficacy, as measured by changes in glycated hemoglobin (HbA1c) and postprandial glucose (PPG), are also presented, along with a range of indications for use and the most frequently cited contraindications. Potential pharmacological interactions are also considered. The review highlights differences between individual α-glucosidase inhibitors and their potential place in therapeutic regimens. The study also highlights the need for further long-term studies assessing the importance of these compounds in the comprehensive metabolic control of patients with type 2 diabetes.

Aim of study. The aim of this review was to present the current state of knowledge about drugs classified as α-glucosidase inhibitors, their mechanisms of action, properties, safety profile, and clinical significance in the treatment of type 2 diabetes.

Materials and methods. The review focused on α-glucosidase inhibitors and their use in the treatment of type 2 diabetes. A literature search was conducted in the Google Scholar, PubMed, and Scopus databases, covering the period from 1995 to 2025, to include review and original research articles.

Results. The literature review on α-glucosidase inhibitors in the context of the treatment of type 2 diabetes showed that acarbose, miglitol, and voglibose demonstrate significant efficacy by inhibiting the enzymatic degradation of oligosaccharides and disaccharides in the small intestine. Analysis of the effectiveness of α-glucosidase inhibitors shows that they reduce postprandial glucose levels and improve the glycemic profile in patients with type 2 diabetes. Despite their beneficial metabolic effects, the most frequently reported adverse events are gastrointestinal disturbances such as flatulence and diarrhea.

Conclusions. The α-glucosidase inhibitors remain an important component of type 2 diabetes treatment, effectively controlling postprandial glucose levels with a moderate risk of adverse events. Individualized drug selection based on pharmacokinetics and patient condition can increase the effectiveness of treatment. However, further long-term studies are necessary to fully evaluate their efficacy and impact on diabetic complications and to determine optimal treatment strategies in various patient populations.

Keywords: α-glucosidase inhibitors, type 2 diabetes, acarbose, miglitol, voglibose.

© Farm Pol, 2025, 81(6): 349–358