Which oral antidiabetic do I use the most?

Dr. Om J Lakhani talks about Acarbose . It is one of the most versatile oral antidiabetic

01:04 🩺 Acarbose: Mechanism of Action and Clinical Applications

Acarbose inhibits enzymes involved in carbohydrate breakdown, preventing glucose absorption.
It primarily acts on postprandial glucose, making it useful in various types of diabetes.
Versatile usage includes type 2 diabetes, type 1 diabetes (in India), pancreatic diabetes, hypoglycemia in pregnancy, and hypoglycemic syndromes.

08:23 📊 Glycemic Variability and Diabetes Management

Glycemic variability, alongside fasting and postprandial glucose, is crucial in diabetes management.
It's assessed through metrics like standard deviation and coefficient of variation, with values above 36% indicating high variability.
Case studies illustrate the impact of glycemic variability on patient outcomes and the role of acarbose in reducing it.

14:25 💡 Acarbose in Reducing Glycemic Variability: Case Study

A case study demonstrates acarbose's efficacy in reducing glycemic variability and hypoglycemic episodes.
Combining acarbose with basal insulin shows significant flattening of the glucose curve, improving overall glycemic control.
The strategy of fixing fasting glucose first, followed by monitoring and adjustment, showcases effective diabetes management.

18:09 📈 Clinical Cases: Acarbose in Various Diabetes Conditions

Clinical cases highlight acarbose's effectiveness in type 2 diabetes management when combined with insulin and other medications.
Acarbose demonstrates utility in pancreatic diabetes, showing improved glycemic control in patients with chronic pancreatitis.
It can be utilized in hypoglycemia, including reactive hypoglycemia, expanding its applicability beyond conventional diabetes treatment.

21:43 🩸 Treatment of Reactive Hypoglycemia

Reactive hypoglycemia mainly occurs in early or pre-diabetic patients due to delayed and blunted first-phase insulin secretion.
Patients experience postprandial hypoglycemia due to a mismatch between glucose and insulin levels.
Acarbose can be effective in treating reactive hypoglycemia by delaying glucose absorption to match insulin secretion.

24:35 🍽️ Mechanism of Action of Acarbose in Post-prandial hypoglycemia

Acarbose delays glucose absorption, preventing postprandial hypoglycemia by blocking alpha-glucosidase enzymes.
It works in the oral cavity and intestine to inhibit carbohydrate breakdown, delaying glucose absorption.
Acarbose is versatile and can be used in various clinical situations, including type 2 diabetes, pancreatic diabetes, and pregnancy.

27:42 🛑 Side Effects and Management

Common side effects of acarbose include abdominal pain and gastrointestinal discomfort.
Side effects reduce over time as the gut microbiota adapt to the presence of unabsorbed carbohydrates.
Reducing carbohydrate intake can help minimize side effects associated with acarbose treatment.

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