(IMPORTANT) SGLT inhibitors are not a substitute for Acarbose

https://pharmrx-1.com/ sells acarbose without prescription, about 80 cents per pill. They accept credit cards. I ordered some before.

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As a reference, this is what I pay for Acarbose here in Spain, no Rx required. Price per mg is same no matter size of tablet. This is for 100 mg. x 100 tablets ACARBOSA 100 MG 100 COMPRIMIDOS
658237
GLUCOBAY (brand name) 100 100MG 100 COMPRIMIDOS
15.30. euros.

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FWIW

I have been very happy with the products I have gotten from India so far.

I continue to use Jakose Nikose even though is a little more expensive than some other suppliers. He has been very reliable and the products are very good.

This is the first time I am ordering Acarbose from India. My first purchase is small because I want to see and test the product.

I am including the response from another supplier: Silverline Medicare Private Limited They are cheaper and I may try them for my next batch.

I have not yet tried this supplier:

This is Rahul Kewalramani from Silverline Medicare Private Limited.

We have Glucobay (Acarbose) 50mg Tablets with the following price:-

360 Tablets – $81 USD.

Shipping fees Extra.

We are the Leading suppliers of Glucobay 50mg Tablets from India. You can search more details about our company on Google.

We hope you have a Great Day ahead.

Regards,

Rahul Kewalramani.

www.silverlinemedicare.com

Silverline Medicare Pvt Ltd

Shop no.501 + 502, 5th floor, Panjwani market,

Jagnath road, Tin nal Square, Nagpur- 440002.

Skype name: silverlinemedicare

WhatsApp Number/ Mobile Number:- +91-8788068934

Viber :- +91-9021240078

Signal :- +91-9021240078

“Where there is the will, there is the way”.

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holy shit, this is huge…

Thanks for posting this. Do you happen to know of a Spanish pharmacy where you can place orders online - and that ships internationally within Europe? Thanks again!

Also, the studies mentioned previously are the acute effects of SGLT2 inhibition postprandially. I’d speculate that regular use of SGLT2 by a non-diabetic would increase insulin sensitivity over time (via visceral fat reduction?), which in turn would lead to improved chronic glucose control/disposal.

On the other hand, SGLT2 inhibitors may cause loss of muscle in addition to fat mass, which is definitely NOT what we want. There are ongoing/upcoming studies exploring this, with mixed results so far.

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@Sash

Thank you for your insightful posts Dr. Rami Abunadar. Do you have any thoughts/potential suggestions why Acarbose and Canagliflozing resulted in an increase in lifespan in male rodents, but not in females?

There is no definitive answer to this, Only some theories. What I sense from your question is that you’re worried that perhaps Acarbose may not confer benefit to you as a female similar to what happened in the mice studies.

Mice after all aren’t exactly like humans. It’s difficult to say what might perfectly transfer and what might not. We’re not even 100% certain sure that any of the ITP studies and effects will actually translate to humans, Nevermind exact sex-specific differences.

But what i do know is there has been over two decades of studies and research on the beneficial effects of Acarbose in humans on cardiovascular disease, Cancer, Incidence of diabetes, Overall mortality…etc. Yet never came across a paper which said or hinted that the benefits only show in males.

There a genetic mutation present in some people that affect the SGLT1 receptors in the gut, Which decreases the post-meal glucose spike throughout their lives, similar to acarbose. This study found that for every 20mg/dl decrease in glucose spike (Which is less large of a decrease than what acarbose might produce). They had 50% less likelihood to die, Develop diabetes and obesity. There was no mention of this effect being only male-specific

So I encourage both males and females to take acarbose based on the available evidence. This is subject to change if some definitive form of evidence emerged against this, Which there isn’t any at the moment. I convinced my wife to start taking acarbose.

@Davin8r

Dr. Rami,
Whenever I check urine glucose while taking empagliflozin (non-diabetic), it is very positive for glucose.
I see the data above, but I don’t understand why .
Even if the initial postprandial blood glucose peak is unaffected, why wouldn’t the area of the curve be decreased since glucose disposal should be faster due to the combined effect of disposal into the urine added with disposal into muscle, liver, etc? Any ideas? Thanks
Also, the studies mentioned previously are the acute effects of SGLT2 inhibition postprandially. I’d speculate that regular use of SGLT2 by a non-diabetic would increase insulin sensitivity over time (via visceral fat reduction?), which in turn would lead to improved chronic glucose control/disposal.

My guess is that in healthy people the peak and the shape of the glucose curve are mostly controlled by the rate of absorption from the gut. SGLT inhibitors which dump glucose into urine, Or drugs like metformin that increase insulin sensitivity will certainly help in decreasing both the peak and AUC of insulin since the pancreas will require less insulin to be secreted by definition, But it won’t necessarily affect the glucose peak or even curve.
The rationale being (At least I suspect) is that when there is less glucose to deal with (as with SGLTI) or it’s easier for tissues to take up glucose (Metformin), The pancreas will simply compensate by secreting less insulin. Hence there will be no change in glucose peak or even AUC perhaps, However, there will be a change in insulin peak and AUC.

Acarbose mechanism in the ITP was most likely due to affecting peak glucose and not simply increased insulin sensitivity. It’s important to remember that metformin which is quite effective in improving insulin sensitivity, Failed to increase lifespan in mice in the ITP studies.

The idea behind my post is to point out that SGLI is not a substitute for Acarbose if one hopes of replicating the ITP studies. Not that SGLI aren’t useful in humans.
I believe that any insulin-sensitizing drugs like SGLTI or metformin will be useful in humans in some form or shape. And if the person is convinced of their benefits based on solid research and understanding of their short and long-term side effects., Then they can choose to take it along with acarbose.

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No, Pharmacy’s do not do that here. Not for drugs. It would help if you would say, where you want it shipped. A big deciding factor.

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Fantastic information; thank you so much for the insightful post.

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Yes thanks, great info and it makes sense. With acarbose, you get decreased calories, decreased glucose AUC and insulin AUC, whereas with SGLT2i you get two out of the three (blunted insulin AUC and decreased calories but no change in glucose AUC for non-diabetics). And there are definitely pros/cons of the side effect profiles for each.

I’ve got some acarbose on the way, so I’m looking forward to trying it! (On my day off from work, while I’m home with the dogs and wife is at work) :laughing:

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Is there any literature that clearly shows that it is post meal spikes in glucose level that causes aging?

No - this is a hypothesis that was conveyed by Richard Miller based on the NIA ITP study results with acarbose and SGLT2 inhibitors…

See: Canagliflozin - Another Top Anti-aging Drug
See: Acarbose - Details On Another Top Anti-Aging Drug

So, Canagliflozin may work perfectly well at extending health span by chronic lowering of glucose levels.

It seems that way, from the mouse studies.

I recommend you read the main thread. In essence, No, You won’t have a lowering of peak glucose like in the ITP studies. Because the way canagliflozin was administered and acted in those mice studies, Won’t translate in humans.

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I have read the thread. My point is that lowering peak glucose is not the mechanism by which Canagliflozin increases life span.

This is correct. It will not lower glucose levels at all if they are not elevated. There may be other possible longevity benefits but this is not one of them.

What do you/your patients do to ameliorate the side effects of acarbose?

People talk about taking beano for the gas, but the even worse issue I keep reading is an uncontrollable need to make a hasty, violent and unpleasant trip to the bathroom. Beano doesn’t solve that, aside from. perhaps, reducing the violence!

Also, it’s my understanding that the gas acarbose causes is, basically, because it’s working as intended. Would taking Beano short-circuit the process (and, thus, benefits)?

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Yes, Beano does partially negate the effects of the acarbose, but only partly:

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Thanks! I didn’t even think to google. I almost didn’t include the question because I thought it might be dumb. Then, I decided, dumb or not, it passed the logic hurdle, so I added it in. Thanks for finding this.

We can all assume that the acarbose-only flatulence score of 1.09 is no joy to be around. While they note the improvement, I’m going to go out on a limb and guess that the acarbose+beano .79 score isn’t an ideal first date flatulence score either!