Miglitol is an oral alpha-glucosidase inhibitor used in the treatment of type 2 diabetes. It works by reversibly inhibiting alpha-glucosidase enzymes in the small intestine, which delays the digestion of complex carbohydrates and subsequently reduces postprandial glucose levels.[1] Approved for clinical use since 1998, miglitol has demonstrated efficacy in improving glycemic control, reducing HbA1c levels, and decreasing both fasting and postprandial plasma glucose concentrations in long-term clinical trials.[1][2] Additionally, recent studies have suggested that miglitol may have potential as an anti-obesity agent, showing promise in reducing body weight and body mass index in obese or diabetic patients.[3] While generally well-tolerated, the most common side effects associated with miglitol are gastrointestinal disturbances, which are typically mild to moderate and tend to decrease over time.[1]
It must be taken at the start of main meals to have maximal effect[4]
In contrast to acarbose (another alpha-glucosidase inhibitor), miglitol is systemically absorbed; however, it is not metabolized and is excreted by the kidneys.
Formulation
The benefits of alpha-glucosidase inhibitors on health were shown to be stronger when the powder is consumed orally dissolved in water as a beverage in comparison to its intake as ordinary hard gelatin capsules.[5]
