Evidence Summary
Acarbose is an effective treatment for diabetes and has shown promise in preventing cardiovascular events in diabetics. It has also been found to extend lifespan in mice. However, it’s important to note that acarbose does not cross the blood-brain barrier.
Neuroprotective Benefit
Due to acarbose’s poor blood-brain barrier penetrance, any neuroprotective benefits are likely secondary to improvements in blood glucose control.
Aging and Related Health Concerns
While effects in healthy adults are not well-established, acarbose has been shown to prevent diabetes in people with prediabetes and decrease the incidence of cardiovascular events in diabetics. In mice studies, acarbose has demonstrated lifespan extension.
Safety
Most reported side effects are mild and gastrointestinal in nature (diarrhea, flatulence, bloating). However, it’s important to note that the majority of safety studies have been conducted in diabetics, and long-term effects in healthy adults remain unknown.
What is Acarbose?
Acarbose is a generic drug used for treating type 2 diabetes. It works by inhibiting α-glucosidase, an enzyme in the small intestines that digests starches and disaccharides into glucose. It also inhibits α-amylase in the pancreas, which breaks down complex starches into oligosaccharides. The overall effect of acarbose is a decrease in blood glucose levels.
Neuroprotective Benefits
Due to acarbose’s poor blood-brain barrier penetrance, any neuroprotective benefits are likely to be secondary to improvements in blood glucose control. There have been no studies directly testing acarbose for dementia or age-related cognitive decline. The only available literature on cognitive outcomes comes from studies on hepatic encephalopathy, a neuropsychiatric condition associated with cirrhosis.
Aging and Related Health Concerns
Type 2 Diabetes: BENEFIT
Multiple meta-analyses have shown that acarbose can help manage type 2 diabetes. It has been found to decrease glycated hemoglobin levels when combined with insulin, and its glucose-lowering effects are comparable to metformin.
Cardiovascular Disease: BENEFIT
A Cochrane meta-analysis reported that acarbose decreases cardiovascular events in people with impaired glucose tolerance (prediabetes). In a separate randomized controlled trial, acarbose treatment resulted in a 34% risk reduction in the development of new cases of hypertension and a 49% risk reduction in the development of cardiovascular events.
Lifespan: BENEFIT
While there’s no evidence in humans yet, mouse studies have shown promising results. In the National Institute on Aging Interventions Testing Program, acarbose increased male median lifespan by 22% and female median lifespan by 5%. Maximum lifespan also increased in both sexes.
Safety Considerations
Most reported side effects of acarbose are mild and gastrointestinal in nature, including diarrhea, flatulence, bloating, and nausea. These side effects often disappear after 1-2 months of use. However, it’s important to note that the majority of safety studies have been conducted in diabetics, and long-term effects in healthy adults are not well-established.
Drug Interactions
Acarbose should not be used with anticoagulants like warfarin, as it may increase the risk of side effects such as bleeding. It should also not be used with drugs that cause hyperglycemia, which may lead to loss of blood glucose control.
Sources and Dosing
Acarbose is sold as Precose in the US. It’s typically taken orally three times a day at the start of each meal. Daily doses range from 50 to 300 mg, depending on the individual’s weight and other medications.
Ongoing Research
Several clinical trials are currently underway, including studies examining the anti-aging effects of acarbose and its potential benefits for postprandial hypotension in older adults.
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Disclaimer: This report is for informational purposes only and should not be used for medical advice, diagnosis, or treatment. Always consult with your healthcare provider when making decisions about your health.
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