What are the indications and contraindications for acarbose

Acarbose is indicated first of all in the prevention of post-prandial hyperglycaemia in individuals with Type 2 DM. Its effectiveness is limited to a decrease of glycosylated haemoglobin by 0.5-1.0 percent when used as monotherapy. It can be combined with a sulfonylurea, metformin, insulin and with the combination of two or even three substances (see the first footnote in Figure 27.1). In all cases, however, its effectiveness is most apparent when the severity of the disease is relatively small. Its indications also include its administration in insulin-dependent individuals (Type 1 DM) in combination with insulin.

Acarbose is contraindicated in pregnant and nursing women and when there are chronic intestinal diseases with definite disturbance in digestion and absorption. Great caution should be exercised when the patient has large hernias as well as ulcers or stenoses of the intestine. Individuals with constipation due to DM should better avoid the intake of acarbose, because the neuropathy of the autonomous nervous system that causes constipation can intensify flatulence and abdominal aches.

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