I find it interesting that some pharmacies combine Acarbose + Metformin for the treatment of diabetes:
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Acarbose is used to prevent lactic acidosis. At least in cattle, but the principle should hold for humans as well, IMHO.
Does acarbose cause lactic acidosis?
Increases in lactate concentrations and decreases in total VFA associated with acute acidosis were mitigated by acarbose. Thus, acarbose, an amylase and glucosidase inhibitor, prevented or reduced the incidence of acidosis in an acute challenge model in steers and was more effective than monensin or sodium bicarbonate.
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Yes, itâs the reason my doc is against it. I guess I have to continue my very strict diet.
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Odd. Its expressly stated on the prescribing guidelines.
I take both, alongside a GLP-1. I am a T2D and My A1C is a 4.5
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âAn estimated incidence of metformin-induced lactic acidosis (MALA) is 6.3 per 100,000 patient-yearsâ, thatâs quite low and there are many reasons for even this small number such as many other medical problems."
âThe symptoms of lactic acidosis are severe and quick to appear. They usually occur when other health problems not related to the medicine are present and very severe, such as a heart attack or kidney failureâ
Lactic acidosis as a side effect of acarbose is not even mentioned on websites such as Web MD, Mayo Clinic, etc. donât even mention this as a side effect, so I imagine it is quite a low number.
Glyburide And Metformin (Oral Route) Precautions - Mayo Clinic.
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Indeed prescription guidelines for acarbose state it should not be prescribed with kidney disease (creatinine < 25 ml/min) but there is this Taiwanese longitudinal study that found:
Our findings support the renaissance of acarbose as a useful adjunct in diabetic patients with stage 5 and 5D chronic kidney disease.
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There is no such warning for acarbose issued in Europe.
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You are correct! I will message my physician and get their take. Id bet I misunderstood them. I do know that there are risks associated with those with renal impairment, such as our wonderful @LaraPo , but it doesnât seem associated with lactic acidosis.
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This study from the University of Wurzburg says try pycnogenol.
https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(06)00456-6/fulltext
We found that PycnogenolÂź exhibited the most potent inhibition (IC50 about 5 ÎŒg/mL) on α-glucosidase compared to green tea extract (IC50 about 20 ÎŒg/mL) and acarbose (IC50 about 1 mg/mL).
I have to give credit where it is due. Hunted that down from the citations of this other article.
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Hmm?
I ordered some French Pine Bark extract containing Pycnogenol. I have used it before for its anti-inflammatory properties, but I did not know about its inhibition of Alpha-glucosidase.
âAlpha-glucosidase inhibitors inhibit the absorption of carbohydrates from the small intestineâ
I also didnât it works in the same manner as acarbose. To use it as a supplement for acarbose you would also have to take it right before meals, which is something I never did.
I am going to do a self-experiment over the next week or so comparing the effect of acarbose vs French pine bark extract. The problem is I donât know the dosage that would be equivalent to acarbose. So, I will start with the recommended dose on the bottle I receive and go from there. I will try to have at least two equivalent meals for each of the tests and I will also see if it has any effect. Also, I will see if it has any effect on my fasting glucose level.
It would be neat if it works as well as acarbose. ( I doubt it in spite of the study.)
Since it works by the same general mechanism as acarbose it probably would be a good substitute and is considerably cheaper.
We found that PycnogenolÂź exhibited the most potent inhibition (IC50 about 5 ÎŒg/mL) on âα-glucosidase compared to green tea extract (IC50 about 20 ÎŒg/mL) and acarbose (IC50 about 1 mg/mL). The inhibitory action of PycnogenolÂź was stronger in extract fractions containing higher procyanidin oligomers. The results obtained assign a novel, local effect to oligomeric procyanidins and contribute to the explanation of glucose-lowering effects of PycnogenolÂź observed in clinical trials with diabetic patientsâ
Oligomeric procyanidins of French maritime pine bark extract (PycnogenolŸ) effectively inhibit α-glucosidase
https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(06)00456-6/fulltext
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Is it a liquid form? What brand? Want to try it as well.
Seems a daily dose of 50-200mg of pycnogenol would be appropriate for BS control. @LaraPo it exists only in pill or capsule. But it is quite expensive. I am taking it few months a year for my skin, it does wonders for hyperpigmentation and discolorations on my skinâŠ
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First, even if thatâs true, it doesnât address even the narrow question. Wormbot administers drugs starting at the L4 larval stage (reproductive maturity at 3 days old); this study confirms met is beneficial to young worms (L4 larval and adults at the age of reproductive decline (AD4)), but is deleterious to middle-aged (AD8) or old (AD10) animals.
Second, even if metformin worked in older worms, that wouldnât mean that it works in older animals. Itâs really very clear now that metformin is useless as an anti-aging agent in mice, and clear enough in humans.
I disagree. Metformin was able to prolong mouse lifespan when combined with Rapamycin by the ITP. It is synergistic with Rapamycin because Rapa gives you a pseudo-diabetic condition that needs to be addressed to obtain optimal lifespan. As long as you are taking Rapa, you should be taking either acarbose or Metformin or both. I am doing the latter - 100 mg x 3 of Acarbose and 500 mg of Metformin daily. I would drop the metformin in old age and stick with acarbose or maybe switch to acarbose + canagliflozin, but with cana there are other issues.
Also, Metformin + Rapamycin completely blocks the formation of fatty liver while each by itself only retards the formation of fatty liver in mice. 25% of Americans suffer from fatty liver disease and it is a silent killer. Metformin is very synergistic with Rapamycin. I agree that Metformin by itself should not be taken to extend lifespan.
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What brand are you using?
Acarbose is relatively cheap, but you do need a prescription. I have found it much easier to get a prescription for acarbose than Rapamycin. Why would you pay for pycnogenol when acarbose is tested and effective?
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White mulberry extract (morus alba) is also a good choice.
Morus alba is another plant species for which AG inhibitory activity has been well-studied [44], and its leaf extracts exhibited AG inhibition activity with an IC50 value of 91.63 ”g/mL compared to that of acarbose (IC50: 402.33 ”g/mL) [45]
That is less than 1/4 the dosage for acarbose.
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First, using metformin to counteract the diabetic effect of rapamycin is different from the effects of met as an anti-aging agent as such, which is what this study was about. The Wormbot data you mentioned were also for met-only treatment, right?
Second, the differences between Met-Rapa and rapa-only treatment are based on comparisons between different studies, which is squishy to begin with, and even at that the differences were not statistically significant by the usual analysis.
Third, a treatment for Disease X is also different from a drug that impacts the aging process.
I think that means we mostly agree. Metformin should not be used as a standalone anti-aging regimen. However, for diabetes, Met-Rapa, and other specific cases, it could be used effectively.
Yes, the wormbot showed 15% life extension with metformin only, so it became the marker that all other interventions were measured against. Some drugs when combined with metformin increased C. Elegans life expectancy by 150% according to Dr. Kaberlein. While they only increased lifespan by 15% on their own. Others lost all life-extending capabilities when mixed with Metformin. When you start combining, you get a mixed bag.