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May be used in type 2 diabetes. Weight neutral and will not cause hypoglycaemia in or of itself
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Does not reduce cardiovascular or renal disease independent of glycaemic control
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Inhibits carbohydrate absorption by inhibiting the intestinal enzyme alpha glucosidase
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Adverse effects of acarbose:
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Bloating and flatulence
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Diarrhoea
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Deranged LFTs (rare)
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Start at 50 mg tds and can increase to 100 mg tds with meals (often need higher dose with low carbohydrate diet)
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If introduced to a regimen with insulin and/or sulfonylureas, then the dose of insulin and/or sulfonylureas may need to be reduced to prevent hypoglycaemia (particularly if the HbA1c is < 64 mmol/mol). NB: If hypoglycaemia does occur in people taking acarbose ensure treatment with glucose, because acarbose inhibits the absorption of sucrose.