A quick question about Acarbose. I understand they inhibit carbs digestion to sugar in gut and reduce the affect of high carb on blood glucose. I also know there are some side affects on long term use of Acarbose. However, my question is can we use a one-off Acarbose dose to mitigate a high-carb meal off and on? Does this work or it has to be build up in blood like Metformin?
Any tried it? If it can be used one-off safely then we diabetics can have a cheat meal without going too off ?
Advice from NICE is that the dose of acarbose should be titrated upwards to reduce gastrointestinal side-effects:-
By mouth
For Adult
Initially 50 mg daily, then increased to 50 mg 3 times a day for 6–8 weeks, then increased if necessary to 100 mg 3 times a day (max. per dose 200 mg 3 times a day). https://bnf.nice.org.uk/drug/acarbose.html#cautions
This suggests that the initial dose may not be high enough to have a significant effect but a dose that is high enough may cause unwanted gastro-intestinal side-effects.
Looking at test results done in USA, it would seem that long(ish) term use of acarbose may lead to an additional weight loss of about 0.5 kg, and a drop in HbA1c of around 0.5% which also would seem to suggest it would not do that much as a meal prophylactic.
Yes, I think it can be effective in single doses. But, used intermittently, you won't build up tolerance to the GI side effects, which can be severe. So may be you take it regular, sort out the side effects (easily available on a Google search,) then may be miss an occasional dose. A*** about face, so to speak.