Your digestive system breaks down complex carbohydrates from food into a form of sugar that can be passed into your blood. The sugar then passes into your blood through the walls in your small intestine.
If you have diabetes, your body has a problem moving the sugar from your bloodstream into your cells. This leaves more sugar, or glucose, in your blood. The treatment of diabetes relies on controlling your blood glucose level. Long-term increased blood glucose levels can eventually cause dangerous complications.
Acarbose, miglitol, and pramlintide are all drugs that help manage diabetes. They each prevent too much sugar from getting into your blood too quickly. They come in different forms and work in slightly different ways.
Acarbose and miglitol are available as generic and brand-name drugs. Precose is the brand-name drug for acarbose. Glyset is the brand-name drug for miglitol. These drugs are all alpha-glucosidase inhibitors.
How they work
Glucosidase is an enzyme in your body that helps convert complex carbohydrates to simple sugars. Alpha-glucosidase inhibitors work by helping to block this action of glucosidase. This helps prevent sugars from passing through your small intestine into your blood. However, alpha-glucosidase inhibitors don’t stop simple sugars (found in foods such as fruit, desserts, candy, and honey) from passing into your blood.
How you take them
Both acarbose and miglitol come in a tablet you take by mouth. You take them with the first bite of each meal. If you don’t take these drugs with the first bite of each meal, they’re much less effective.
Who can take them
These drugs are approved to treat people with type 2 diabetes. They’re usually prescribed to people with type 2 diabetes whose blood sugar levels get too high after they eat meals high in complex carbohydrates. It can be used alone or with other diabetes treatments.
Alpha-glucosidase inhibitors are not ideal for everyone. They’re also not usually prescribed to people who are younger than 18 years or women who are breastfeeding. If you have severe digestive disorders or liver disorders, your doctor may suggest an alternative treatment.
Pramlintide is an amylin analogue. It’s only available as the brand-name drug SymlinPen. That means you won’t find it as a generic drug.
How it works
Typically, the pancreas releases natural amylin each time you eat. However, in some people with diabetes, the pancreas doesn’t make enough or any natural amylin. Amylin slows the absorption of sugar into your blood by decreasing the speed at which food leaves your stomach. It also helps decrease your appetite and increase feelings of satiety and fullness.
Amylin analogues like pramlintide mimic the action of natural amylin. They decrease how quickly food leaves your stomach, helping you feel fuller, and they slow the absorption of sugar into your bloodstream. Pramlintide promotes both blood sugar control and weight loss.
How you take it
Pramlintide comes as an injectable solution in a prefilled injectable pen. The pen is adjustable so that you can set it to give you an exact dose.
You inject pramlintide yourself under the skin of your abdomen or thigh. You give yourself an injection before each meal. Use a different injection site each time you give yourself a pramlintide injection. If you also use insulin with pramlintide, make sure you inject pramlintide in a different spot from where you injected the insulin.
Who can take it
Pramlintide is approved for use in people with type 1 and type 2 diabetes who are 18 years or older. Pramlintide can be used alone as treatment. It can also be used with insulin to provide extra help in controlling blood sugar levels.
Pramlintide delays the absorption of any drug you take by mouth. Do not use any oral medications within one hour before using pramlintide or two hours after using pramlintide.
Also, you should always monitor your blood sugar closely while taking pramlintide. You may experience severe hypoglycemia (low blood sugar) within three hours after taking it. Symptoms of hypoglycemia include:
- concentration problems
- sweating for no reason
If you check your blood sugar and find you have hypoglycemia, eat some hard candy or glucose tablets. If your blood sugar levels drop too low, you risk:
- loss of consciousness
Acarbose, miglitol, and pramlintide can cause side effects for some people, including dizziness and drowsiness. There are also side effects unique to each type of drug.
Other side effects of acarbose and miglitol include:
- abdominal distention (expansion of the abdomen)
- increased liver enzyme levels
- severe allergic reaction
Unique side effects of pramlintide include:
- joint pain
- loss of appetite
- runny nose
- sore throat
Acarbose, miglitol, and pramlintide may also cause negative side effects if each is combined with other drugs. Other drugs that may interact negatively with each are detailed in the Healthline articles for pramlintide, miglitol, and acarbose.
Acarbose and miglitol are both alpha-glucosidase inhibitors, so they work similarly. They’re typically used just for type 2 diabetes.
Pramlintide is used for both type 1 and type 2 diabetes. It’s used by itself or as an addition to insulin in combination treatments.
For more information about whether any of these drugs may be appropriate for you, talk to you doctor. You doctor knows the history of your diabetes as well as the rest of your medical history. This information is important in deciding the right treatment for you.