The hypoglycemic mechanism of metformin and acarbose is different.
Metformin mainly reduces blood sugar by inhibiting the source of glucose and increasing glucose.
The sources of inhibiting glucose include inhibiting the transformation of hepatic glycogen into glucose and reducing the absorption of glucose by intestine.
The way to increase glucose is to increase the uptake and utilization of glucose by peripheral tissues, that is, to promote the uptake and utilization of glucose by muscle cells and fat cells, so that excess glucose can be converted into muscle glycogen and fat storage, while increasing anaerobic glycolysis of cells, promoting the utilization of glucose, thus reducing blood sugar.
Metformin does not increase insulin secretion, and does not cause hypoglycemia in normal people and patients with type 2 diabetes. It can reduce fasting blood glucose and postprandial blood glucose of diabetic patients. Metformin can also reduce plasma levels of free fatty acids and triglycerides, reduce body weight, inhibit platelet aggregation, restore platelet function, directly improve vascular endothelial function, increase blood flow and reduce various risk factors, thus protecting the cardiovascular system.
Acarbose mainly reduces glucose produced by hydrolysis of carbohydrates such as starch, maltose and sucrose by competitively inhibiting α -glucosidase in small intestinal epithelium, reducing and delaying the absorption of glucose, thus reducing postprandial blood sugar. Long-term use can reduce fasting blood sugar and urine sugar, as well as triglyceride and weight loss.
Metformin and acarbose have similar indications.
Metformin is mainly used for patients with mild and moderate type 2 diabetes who are ineffective in simple diet control and physical exercise, especially obese type 2 diabetes. Metformin can achieve satisfactory results for patients with type 2 diabetes who are not satisfied with the therapeutic effects of gliclazide, acarbose and insulin. Metformin combined with gliclazide XX is superior to single drug in the treatment of newly diagnosed type 2 diabetes, and metformin combined with gliclazide XX can also be used to treat failed patients with secondary diabetes. Combined therapy with insulin can reduce the dosage of insulin in patients with 1 type diabetes or type 2 diabetes.
Acarbose can be used alone or in combination with other hypoglycemic agents, especially for obese patients with early type 2 diabetes, mainly manifested as postprandial hyperglycemia, which can delay the development of impaired glucose tolerance to diabetes. Usually combined with insulin, gliclazide, metformin and other hypoglycemic drugs to treat patients with poor single-use effect, enhance hypoglycemic effect, reduce drug dosage and reduce adverse reactions.
Which is faster to lower blood sugar, metformin or acarbose?
Metformin is mainly absorbed in small intestine after oral administration, such as metformin hydrochloride tablets (Gehuazhi). Pharmacokinetic tests of this product in China show that the peak time of blood drug concentration is 2 hours, that is, about 2 hours, and the hypoglycemic effect reaches the maximum. For example, the pharmacokinetic test of metformin hydrochloride enteric-coated capsules in China shows that the peak time of blood concentration is 2.7 0.5 hours, that is, about 2.7 hours, and the hypoglycemic effect reaches the maximum. All of them are excreted mainly through the kidney, and 90% of them are excreted through the kidney after 24 hours.
Acarbose is hardly absorbed by human body, and mainly acts in intestine. During taking the medicine, the proportion of carbohydrates in the diet should be increased, and the intake of monosaccharides, such as glucose and fructose (rich in fruits), should be restricted to improve the curative effect of the medicine.
Acarbose directly acts on the intestine, only reducing and delaying the absorption of glucose, while metformin can reduce blood sugar in many ways, and the speed of metformin is relatively faster.