Miglitol - Wikipedia gets absorbed - we urgently need ITP on this. Why can’t we just do lower-sample size and much denser analytics?
1 Like
Could this be possibly downstream from blunting glucose spikes?
The multiple morbidities are actually secondary to diabetes rather than glucose per se . If it were strictly glucose then very strict glycemic control of diabetics would greatly lower end organ damage and mortality rates. Very major studies have shown that that is actually not the case.
3 Likes
I thought that the longevity effects of Acarbose were due to gut microbiota changes. The question then would be - are carbs in the diet required for this to happen? Does Acarbose do anything if you’re on a Leto diet?
Unless you are planning to eat lots of carbs or have a diabetic problem already I’d recommend against using Acarbose. It will change your microbiome as certain bugs get starved out when they can’t process glucose anymore. It causes bad gas too. The whole lesson to be learned from Acarbose is to control your glucose spikes as they cause a whole host of damage to your tissues that results in inflammation. I personally eat slow carbs (low glycemic index) with lots of soluble and insoluble fibers (yes, brings on the gas too!). I also tend towards high protein keto as well but I think we are designed for slow carbs. Slow carbs were survival foods just 2000 years ago. Good times you porked on meat, fat, and berries when you could get them. Otherwise to was the tough nasty taters. And they were nasty and tough too.
Its really not understood yet - see here: Acarbose - Details On Another Top Anti-Aging Drug
Rich Miller’s current interpretation of the life extension benefits of acarbose is that it is blocking the very highest levels of glucose. He suggests that in humans, we often look at hemoglobin A1C, which gives you a measure of avg. blood glucose over the last few weeks, and if a person with diabetes takes acarbose, that hemoglobin A1C goes down — signifying that it’s working in a person, but in mice it turns out that HbA1c does not go down. Therefore, he suggests it’s probably not an overall change in the amount of glucose that gets in, but a change in how quickly the glucose enters the blood stream.
1 Like
KarlT’s observation finds support in a 2019 paper from Richard Miller et al.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567620/
The more recent paper of Chinese scientists (jULY 11, 2022) cites Miller’s paper, and further states:
The effect of acarbose on intestinal fermentation products may influence its overall effect on host physiology. SCFAs are the main products of starch fermentation of intestinal bacteria, which are beneficial to health, and a positive correlation has been reported between SCFA levels in mice feces and their survival rates [14]. Acarbose could influence both the composition of the bacterial community and SCFA levels in mice feces. Changes in the butyric and acetic acid levels after acarbose treatment vary in different populations from different countries. The acetic acid and butyric acid levels were found to increase after acarbose treatment in most populations in Germany and the United States [33-35], but no significant difference was observed in the butyric acid level after acarbose treatment in diabetic populations in China [36]. In nondiabetic people in the United States, the butyric acid levels increased, whereas the acetic acid levels did not significantly change after acarbose treatment [37]. In feces of centenarians in China, seven characteristic compounds (i.e., total SCFA; manganese; cobalt; and acetic, propionic, butyric, and valeric acids) were identified. This metabolic pattern, particularly the increase in the levels of total bile acids and SCFAs, may have an important and positive effect on longevity [38]. In another study of centenarians in Sardinia, their intestinal microbiota showed potential health promoting characteristics, which was related to the high capacity of glycolysis and SCFA production, leading to the extension of lifespan[39]. For instance, in mice fed with acarbose, the abundance of the SCFA-producing bacteria Lactobacillus increased [40]. Besides their anti-inflammatory effects, SCFAs can also regulate immunity [41]. In addition to well-known SCFAs, such as acetic, butyric, and propionic acids, other SCFAs have the ability to extend the life span. For example, formate can reduce the generation of reactive oxygen species (ROS), which can also extend the life span.
Thus, acarbose affects longevity by influencing the abundance of SCFAs [42].
Michael Lustgarten also has a video on SCFAs and longevity:
7 Likes
This rings true, and makes more sense than the glucose peak theory. I don’t think glucose peaks could amount to much A1C change for a metabolically healthy person. A1C is a 100-120 day period of average glucose 24 hours a day. A spike lasting an hour 3 times (meals) a day would have to be huge to move the overall average by much.
2 Likes
Yes, acarbose does not have much effect on the A1C, but it is the glucose spikes AND the triglyceride spikes that do the damage.
Acarbose has other lifespan/healthspan properties in addition to controlling glucose spikes.
I was unaware of the lipid-lowering effects. Some of the effects that I attributed to pantethine may have been due to acarbose. In any case, my lipids have been at an all-time low since I started these two supplements.
I initially was not a big fan of acarbose, mainly because of the effect it had on my digestive tract and the bloating and gassiness it produced.
As RapAdmin pointed out, by reducing or eliminating grains, especially wheat from the diet, most of the bad effects will go away. Since I have switched to a very low-carb diet the side effects have completely gone. Even though my diet alone eliminates any but the most minor glucose spikes after a meal, I still continue to take acarbose because it also eliminates lipid spikes.
This is from one of the best reviews of acarbose that I have come across. It references Meta, Cochrane, and other systematic reviews.
“The beneficial effects of acarbose therapy on serum lipids have been well described. Initial research by Hillebrand et al,81 from a double-blind crossover study, showed that acarbose has a dose–dependent effect for reducing postprandial total triglycerides, with a 200 mg dose being the most effective.”
I think most people taking acarbose are unaware of its lipid-lowering effects.
“There was a 26.8% decrease in mean triglycerides among the acarbose group, compared to 9.2% in the metformin group, and an 8.8% reduction in the placebo group. The LDL-C level increased by 5% in the placebo group, but was reduced by 21.8% with acarbose treatment, and remained unchanged with metformin treatment (p=0.0065 for acarbose vs placebo”
“Acarbose has also been found to improve vascular health and also likely has antiplatelet effects. Lastly, acarbose has been shown to provide euglycemia, partially by increasing GLP-1 levels and blunting postprandial spikes of glucose and lipid levels.”
Euglycemia a noun:
"The condition of having a normal concentration of glucose in the blood; good glycemia regulation; good glycemia.
“Also, these authors showed that acarbose further potentiates the postprandial reduction of ghrelin, thus suppressing appetite”
“Acarbose: safe and effective for lowering postprandial hyperglycaemia and improving cardiovascular outcomes”
8 Likes
That’s quite a list of benefits. It is so long I’m inclined to believe it is a fasting or CR mimetic. Why do glucose spikes cause “damage” if they don’t last very long?
1 Like
There are quite a few papers citing the risk of glucose spikes. This is just one.
“glucose monitoring devices have revealed that postprandial spikes of hyperglycemia occur frequently, and may be an important determinant of CVD risk. It is proposed that these short, intermittent bursts of hyperglycemia may have detrimental effects on several organ systems including the vasculature and the hematopoietic system collectively contributing to the state of elevated CVD risk in diabetes.”
4 Likes
@desertshores This is helpful. Thanks. I still have to research why short term higher glucose causes “higher oxidative stress”? Perhaps it is related to insufficient glutathione common in metabolic illness.
Considering all these beneficial effects of Acarbose, it is very surprising why it’s rarely used by mainstream physicians for any purpose.
3 Likes
Car crashes don’t last very long either but they can certainly cause a lot of damage. I view glucose spikes in a similar yet obviously not as severe fashion.
I believe the biggest advantage of Acarbose is the SCFA production. Instead of having your gut microbiome convert carbs into sugar, you are having your biome turn the carbs into SCFAs which are cardio and Neuro protective and also reduce blood pressure.
4 Likes
This study says glucose spikes are damaging only with insulin resistance (chronically high blood glucose)…in rats.
2 Likes
Yes - I think that may have traditionally been thought to be the case…
But the NIA ITP studies with Acarbose and Canagliflozin seem to indicate otherwise (though by no way is the case closed, I think). The fact that Acarbose and Canagliflozin are so successful in lifespan extension while lowering blood glucose spikes via different mechanisms, suggest that the blood glucose spikes are harmful.
4 Likes
I’d rather achieve very high fecal bile acid and SCFA from my food.
The massive quantities of dietary fiber I tolerated in my 40s and early 50s weren’t working so well in my late 50s but everything is fine now that I am taking digestive enzymes. I’m getting around 50 g fiber/day with about 1500 kcal/day.
2 Likes
What enzymes do you use?
Wholesome Wellness Digestive Enzymes 1000MG Plus Prebiotics & Probiotics Supplement, 180 Capsules, Organic Plant-Based Vegan Formula for Digestion & Lactose with Amylase & Bromelain,
I’m sure there is better and cheaper but I got tired of looking and they work.
2 Likes
Thanks. I have use Doctors Best Digestive Enzymes off and on. I couldn’t say if it helped. I’ll try yours.