Contraindications

If you already suffer from an intestinal disease such as Crohn’s disease, ulcerative colitis, alpha-glucosidase inhibitors should not be taken in order to avoid further strain on the intestinal structures. Since the increased gas formation in the intestine also increases the general pressure in the abdomen, alpha-glucosidase inhibitors should not be taken in the case of hernias (inguinal hernia, hub hernia, diaphragmatic hernia). Heart complaints can also prohibit the use of alpha-glucosidase inhibitors.

Your doctor will discuss a cost-benefit analysis with you. In the case of severe kidney dysfunction, alpha-glucosidase inhibitors must be avoided at all costs in order to avoid a deterioration in organ function. If you want to avoid an overproduction of intestinal gases and a sometimes involuntary release of winds for professional or private reasons, the use of alpha-glucosidase inhibitors is not recommended.

Possible interactions

If you are taking alpha-glucosidase inhibitors and additionally another blood sugar-lowering medication, the risk of hypoglycaemia increases. The insulin requirement decreases when alpha-glucosidase inhibitors are also taken, as a steep rise in blood sugar is suppressed from the outset. Specific interactions between alcohol and alpha-glucosidase inhibitors are not known.

Nevertheless, patients with type 2 diabetes should be cautious with alcohol! Alcohol inhibits the supply of glucose in the liver, which lowers blood sugar levels. This can lead to hypoglycaemia hours after drinking alcohol.

This does not necessarily mean that diabetics have to give up alcohol completely. Moderate amounts (up to 10g/day for women and 20g/day for men; equivalent to 0.33l beer or a glass of wine) can be consumed occasionally in conjunction with carbohydrate-rich meals. This has hardly any noticeable effect on blood sugar.

The costs

Alpha-glucosidase inhibitors are only available in Germany on prescription. Both miglitol and acarbose can be purchased in large and small packages. Acarbose is currently available in packs of 21 and 105, Miglitol in packs of 30 and 120. The prices are similar, but in most cases the costs are covered by the health insurance except for a deductible of 10% or at least 5€.

Alternatives to an alpha-glucosidase inhibitor

In addition to alpha-glucosidase inhibitors, there are a number of other medications to combat diabetes and lower blood sugar. The simplest option is insulin, which is injected under the skin and acts as a hormone that directly lowers blood sugar. Insulin facilitates the absorption of sugar into the liver cells and also inhibits the supply of new sugar to the liver.

Sulphonylureas, which include metformin, for example, stimulate the insulin-producing B cells in the pancreas and thus also lower blood sugar levels. With the help of so-called SGLT2 inhibitors, the reabsorption of sugar in the kidneys can also be inhibited, thus increasing excretion via the urine. You can read more information about insulin here.