Miglitol

Miglitol is indicated for the treatment of type 2 diabetes mellitus in adults when diet and exercise alone do not provide adequate glycemic control. It may be used as monotherapy or in combination with other antidiabetic medications such as metformin, sulfonylureas, or insulin.

Miglitol reversibly inhibits membrane-bound intestinal alpha-glucosidase enzymes in the brush border of the small intestine. These enzymes normally hydrolyze complex carbohydrates (oligosaccharides) into simple sugars like glucose. By inhibiting this process, miglitol delays carbohydrate digestion and glucose absorption, resulting in a more gradual rise in postprandial (after-meal) blood glucose levels.

Miglitol should be taken at the start of each main meal for maximum effectiveness. Common side effects include gastrointestinal symptoms such as flatulence, diarrhea, abdominal pain, and bloating due to fermentation of unabsorbed carbohydrates. When used with insulin or sulfonylureas, miglitol may increase the risk of hypoglycemia and doses of these agents may need adjustment. It is contraindicated in patients with inflammatory bowel disease, intestinal obstruction, or chronic digestive disorders. Not indicated for type 1 diabetes or diabetic ketoacidosis.