Acarbose
This drug works by delaying the absorption of carbohydrates (they are broken down into glucose) from the gut. Therefore it can decrease the peaks of blood glucose that occur after meals. When a patient cannot use other drugs to reduce blood glucose levels, acarbose is used. It can also be mixed with glucose-reducing other medicines. There are gut-related side effects when using acarbose, such as wind, diarrhea, and bloating. Therefore, doctors advise patients not to use it regularly.
Dpp-4 (Dipeptidyl Peptidase-4) Inhibitors
This drug is also referred to as an incretin enhancer. They include alogliptin, linagliptin, saxagliptin [4], sitagliptin, and vildagliptin. Dipeptidyl peptidase 4 (DPP-4) is a chemical (enzyme) that degrades hormones called incretins. Incretins are chemical compounds that are synthesized by the gut (intestine) in response to food. They perform the following functions: help keep you feeling satisfied after eating, regulate the body’s production of insulin [5], and reduce the production of glucagon, which increase blood glucose level. DPP-4 decreases blood glucose levels by enhancing the effects of incretins as they stop DPP-4 from working.
One of these drugs can be used with metformin or sulfonylurea, or both if the HBA1c level is still high. They rarely have side effects, and when present, they are mild. They include feeling sick, flatulence (wind feeling). Excess consumption of vildagliptin can cause liver damage. Therefore, patients are always advised to check their liver function and blood test before using this drug, and they should also run these tests at regular intervals. Any strange feeling after consuming any of these drugs should be reported to a doctor immediately.