That entirely depends on insulin sensitivity as a function of time (and it DOES change per unit of time).
It decreases HbA1c in some studies.
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it seems to inhibit the enzyme that breaks down carbs into glucose, which kind of turns the carbs into insoluble fiber (yes, you do get the fiber like side effects)
If I take 100mg, i can pretty much eat as much carbs as i want for a short period of time, with no movement on my glucose monitor.
It doesnt make you feel full for longer, but it does get rid of the glucose high which is usually followed by the crash and then cravings, so it is somewhat helpfull.
I use it only when I decide to have a heavy carb cheat meal to minimize the damage
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Seems like Acarbose may be coming back:
This paper argues for increased use of acarbose as an antidiabetic drug due to its positive effects on GLP-1 and cardiovascular protection.
The following are the advantages of acarbose: It is one of the rare agents that has been shown to prevent diabetes in the pre-diabetic period; the rate of hypoglycemia is low; its annual cost is lower than that of new antidiabetic drugs; it has weight-loss properties, or at least is weight neutral; it has a positive effect on the lipid profile by lowering the triglyceride level; and there is increasing evidence to show that it reduces the risk factors of cardiovascular disease.
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Acarbose suppresses symptoms of mitochondrial disease in a mouse model of Leigh Syndrome
Here we show that another drug that extends lifespan and delays normative aging in mice, acarbose, also suppresses symptoms of disease and improves survival of Ndufs4-/- mice. Unlike rapamycin, acarbose rescues disease phenotypes independently of mTOR inhibition. Furthermore, rapamycin and acarbose have additive effects in delaying neurological symptoms and increasing maximum lifespan in Ndufs4-/- mice. We find that acarbose remodels the intestinal microbiome and alters the production of short chain fatty acids.
Supplementation with tributyrin, a source of butyric acid, recapitulates some effects of acarbose on lifespan and disease progression. This study provides the first evidence that alteration of the gut microbiome may impact severe mitochondrial disease and provides further support for the model that biological aging and severe mitochondrial disorders share underlying common mechanisms.
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I am planning to add acarbose and empagliflozin to my stack. Prior to that I plan to get some bloodwork done, and follow up with the same tests some months later. I was hoping to do the Levine Phenotypic Age Calculator (even though I am not sure how important that is). Life Extension (LEF) offers test for all the required measurements except for Lymphocyte %. So I wonder if I could get a pretty good approximation by simply dividing the total by 9 instead of ten. What do you think? I will do fasting Insulin at the time. So far my bill is up to $106 at LEF. Are there any other tests that are really important to do (or at least consider) before adding acarbose & empagliflozin to my stack that already includes Rapa (and probably too many supplements)?
OK. Be aware and careful if taking both acarbose and empagliflozoin (or any SGLT2 inhibitor) as they not only lower the blood glucose spikes, but they also lower the entire curve of blood glucose, so you have to be careful you don’t get hypoglycemic. I use one or the other, rarely do I use both. See details in this post here: Canagliflozin - Another Top Anti-aging Drug - #64 by MAC
On the issue of blood testing and Levine calculations - I regularly use the life extension blood tests - the CBC and CRP blood tests - for a total cost of around $70 I think - and they provide all I need for the Levine calculations. The lymphocyte % is included in the basic CBC report.
See details here: A Friendly, Biological Age Reduction Competition?
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Thank you very much for the information and heads up. Much appreciated. Like @desertshores I like to keep my rapamycin intake relatively isolated from other meds/supplements (though not extremely so). What I have been thinking is that for the 6 days between Rapa doses I would take acarbose (25mg) for 3 days and then empagliflozoin/jardiance (10mg) for 3 days. Does that make sense? Or is there any reason that 6 days on acarbose the first week and then 6 days on empagliflozoin the second week would be better?
BTW, generally, do non-diabetic people take acarbose or empagliflozoin just once a day or with each meal?
Acarbose is a drug you take “with the first bite of a meal”, with every meal.
Cangliflozin / SGLT2 inhiibitors are something you take at the beginning of the day (only once) and it lasts all day.
I usually just take empagliflozin, and only occasionally dose with acarbose in specific situations (e.g. when eating pizza late in the evening with friends, a time when perhaps my SLGT2 inhibitor is at a low point in terms of blood levels.
Acarbose can be rather bad on the side effects, especially when taken with a wheat-oriented meal.
There is no data on optimal dosing schedules around rapa and SGLT2 inhibitors or acarbose, so your guess is as good as mine.
Thanks much! After getting the bloodwork done, I will add these to my longevity stack and monitor. Fortunately, I want to cut back on wheat anyhow. 
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acarbose only needs to be taken with a meal, if that meal has carbs in it. if not, then I dont think there is any need. Acarbose doesnt last very long, hence the need to take it at the begining of every meal (up to 3 times a day)
Didn’t you post a study a few months back suggesting that empagliflozin worked better with nightly vs morning dosing?
I think it was an idea thrown out in a discussion, but I’ve not gotten around to testing it at the same time I’m using my CGM. Perhaps someone else has tried it?
Since I use time-restricted feeding, usually a 5-6 hour window an empagliflozin has a half-life of about 12 hours, which also begs the question of how much I am accumulating in my system with daily dosing, I take it ~1 hour before my first meal of the day.
“The total body clearance of empagliflozin is 10.6 L per hour and the expected half-life of empagliflozin is around 12.4 hours. The long half-life of empagliflozin permits once-daily dosing.”
Acarbose’s longevity capabilities is not only from preventing blood sugar spikes after meals I think. Probably more important is its gut microbe effect. The increase of butyric acid is noticeable after very short usage, and other SCFA’s for that matter. There is a reason why almost all centenarians has very healthy guts, it makes you live longer and healthier.
If you have bad reactions from Acarbose that you can not tolerate, I suggest to try something called ButyrAid from NutriCology. I am using is once a day, with Acarbose once a day. It is fantastic. Immediate results. ButyrAid 100 Tabs
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I think that you may be right . The alterations in the microbiome may be the biggest benefit.
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FYI:
Metformin, acarbose, and sitagliptin monotherapy effectively decreased fasting and postprandial blood glucose levels (p<0.001). Acarbose group displayed specific cluster and enterotype mainly composed by Ruminococcus 2 while Lactobacillus was the dominant bacterium in the enterotype of the other three groups. The relative abundance of genera Ruminococcus 2 and Bifidobacterium was dramatically higher in acarbose group. Metformin and sitagliptin increased the relative abundance of genus Lactobacillus. Metagenomic prediction showed that the functional profiles of carbohydrate metabolism were enriched in acarbose group.
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Goran, have you looked at sodium butyrate? It contains a full 600mg butyrate per capsule (vs 100mg for the calcium/magnesium butyrate) and doesn’t have all that extra ca/mg (of course, it does have sodium). Anyway, seems like a much more effective and cheaper way of getting a much larger dose of butyrate:
Gut Health Supplement 60 Caps - Butyrate + Sodium | The Ultimate Postbiotic | No Bloating | No Gas | Great Poops | Supports Healthy Digestion | Leaky Gut Repair | No Filler or Additives by BodyBio Amazon.com
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Very interesting.
All 3 drugs reduced postprandial glucose levels.
They also all had significant effects on the microbiome.
Seems that acarbose May be superior regarding the gut effects in diabetics.
However, I don’t like the fact that acarbose reduces the microbial diversity.
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So for those taking acarbose, what is your dosing?
I have looked at sodium butyrate and magnesium butyrate. I will try the sodium variant next time. I like to experiment. Will put an order in for this.