Combination of Rapamycin, Acarbose, and SGLT-2 inhibitor

Currently I am only taking rapamycin, but am considering both acarbose and a SGLT-2 inhibitor, specifically Jardiance. I am curious if anyone has tried this combination or a similar one. If so, did you notice any effects, good or bad? Are you still on this protocol? Any advice? Anyone think this trio is not a good idea?

i am 70 currently taking all three, daily 10 mg Jardiance, acarbose 25 mg twice on two meal time every day, 4 mg rapamune once a week, no adverse effect, lost ten pound and and able to maintain weight at 150 lb.

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Yes - I use all three. I started with canagliflozin then moved over to empagliflozin / jardiance. I’ve written about my experience here: Canagliflozin for Anti-aging - One Month and 4 Month Updates

Now I’m on empagliflozin and acarbose (50mg or 100mg) (PRN, as needed, when I take breaks from the SGLT2 inhibitor. Acarbose is much better with a diet that avoids wheat (for me, from a side effects perspective). More details here: Acarbose - Another Top Anti-Aging Drug

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Today on twitter: (ACA = acarbose, Cana= Canagliflozin

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Currently, I am taking 4 medications to control blood glucose. High glucose causes inflammation of arteries feeding the kidneys, heart, brain and all other organs throughout the body. Inflammation= plaque buildup and “hot plaque” which causes embolism. Controlling inflammation and arterial health is top priority for me. I currently take Rapa, Metformin, Jardiance, and Acarbose. Use Beano to control gas caused by Acarbose. 76 yo, 75 kg, 180 cm

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I guess Agingdoc1 didn’t look up the actual human trial data and overlaid to a true keto diet? The blunting is actually a complete shift shifting down. So potentially an unsafe bias for true low glucose ketogenic diets? (at least at “therapeutic” doses). It would be interesting, since keto is lower starting glucose and far lower post prandial spike. Only a trial would elucidate.

CANA

EMPA

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Thank you RapAdmin and MAC for your many informative posts. MAC, I think your point is that, if one is on a true (strict) keto diet, then supplementing with acarbose and an SGLT-2 inhibitor might well lower blood glucose too much; am I correct?

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Yes, that’s my theory. Since these meds shift the entire curve down, not just blunt the spike, there is significant hypoglycaemic risk, especially if you adhere to a strict keto, low blood glucose diet.

When I played with a freestyle libre glucose monitoring device for a few weeks, post prandial glucose rose very minimally. I had a glass of orange juice once just for fun, it skyrocketed.

I agree with Mac on this - if you’re already very low carb, you are not getting much in the way of blood glucose spikes anyway, so its probably not worth the time, effort, money and risk to add these blood glucose control medications, and it might lower your blood glucose too much and be harmful.

I don’t take acarbose and empagliflozin at the same time because that seems redundant as we are trying to blunt glucose spikes, and that is well achieved (in my experience) by either one alone. I may try them together in the future though, and with close blood glucose monitoring to make sure I’m not hypoglycemic, just to see how it modifies things.

For me, eating mostly a veggie and fish diet, its been good though. I avoid simple carbs / breads / sugars, etc. and my blood sugar is typically in the range of 80 to 110, which is exactly my target range.

When you do take either acarbose or empagliflozin you take it with the first bite of a meal that contains some carbs, correct?

No - not exactly correct.

For Acarbose - that is the case - I take the acarbose (25mg, 50mg or 100mg, etc.) with the first bite of the meal.

But with the SGLT2 inhibitors I take it 1 hour or more before the meal. The SGLT2 inhibitors take longer to get into the blood system and become effective.

Here is the blood curve for canagliflozin:

Source: https://accp1.onlinelibrary.wiley.com/doi/pdf/10.1002/jcph.88

Here is the full insert for Canagliflozin - good to read and review prior to taking the drug: