#185

The effect of acarbose treatment on anthropometric indices in adults: A systematic review and meta-analysis of randomized clinical trials !

“Acarbose treatment decreased body weight, BMI, and WC in adults…”

Open Access Paper:

https://www.clinicalnutritionopenscience.com/article/S2667-2685(24)00054-8/fulltext

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#186

Sorry to be late in on this discussion. I believe the microbiome changes are a result of the carbohydrates not being absorbed, and are thus metabolized by fermenters, as is the case with soluble fibre and resistant starch. Taking it with carbohydrates seems to make sense… but not for a meal of meat.
Do you think I’m missing something?

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#187

I haven’t read the entire thread, but have they tested acarbose without meals to see the effect that has, i.e taking acarbose at night for humans? I am agnostic to mechanism.

#188

No, only that it has been suggested that acarbose may have other mechanisms of life extension than glucose suppression.

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#189

Posted this elsewhere but want to include it here too.

Association of Acarbose with Decreased Muscle Mass and Function in Patients with Type 2 Diabetes: A Retrospective, Cross-Sectional Study - PMC.

https://www.ncbi.nlm.nih.gov/books/NBK493214/#:~:text=Post-marketing%20reports%20include%20cases,%2C%20metformin%2C%20and%20sulfonylureas%20monotherapy.

“Acarbose may decrease muscle mass and strength in patients with type 2 diabetes mellitus (T2DM). One study found that acarbose decreased skeletal muscle index, handgrip strength, and gait speed more than other drugs, such as insulin, metformin, and sulfonylureas. Acarbose may also delay the absorption of carbohydrates taken to treat hypoglycemia caused by physical activity. When combined with insulin or insulin secretagogues, this can increase the risk of hypoglycemia“

Makes me wonder if I’m doing myself a disservice by taking it, given how much I exercise.

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#190

I should mention it doesn’t say whether these people exercised in combination with Acarbose. Previous studies showed positive benefits of the combination for weight loss and glycemic control. I wonder if lifting weights would offset the potential negatives on muscle mass from Acarbose.

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#191

I have noticeable main gains on acarbose (50mg) though I only use it during meals on the higher carb side so generally I use it 1-2x a day. I don’t take acarbose with meals with little carbs (salmon, meat meals etc) I do weight lift and eat high protein, also no problem maintaining my muscle.

I thought metformin was the one that had negative impact on exercise/muscle mass, not acarbose? I could be wrong though.

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#192

You may want to do periodic (every 6 month) DEXA scans to track your body composition. I’m going to do this, and will post results. I’m not too worried about acarbose - I continue to grow my muscles with regular workouts (and rapamycin, empagliflozin and acarbose).

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#193

That’s a good idea. I’m also growing muscles just fine in spite of Acarbose as well (I also use Rapamycin and Empagliflozin), I think resistance training probably overpowers any potential negative if I had to guess.

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#194

I’d assume T2D patients, on the whole, do not exercise much.

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#195

I’m new here and just started Acarbose. I’ve started on 100mg, three times daily (at start of each main meal). I’m planning to increase to 200mg in a few months time. “Buying” experience was pleasant - I asked my GP for a prescription and filled it at my local pharmacy.

In addition to the Acarbose, I have been taking Akkermansia (Probiotic). Not sure if this has helped, but my gas side effects haven’t been anywhere near the ‘room clearing’ / ‘find a new wife’ scale described by others on here!

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#196

I’m also growing muscles just fine in spite of Acarbose as well (I also use Rapamycin and Empagliflozin), I think resistance training probably overpowers any potential negative if I had to guess.

I don’t think rapa has prevented me from making gains directly, but I do think it suppresses my appetite which does indirectly. I haven’t taken acarbose as consistently but I think it might also. I’m naturally very lean though and I don’t have a strong hunger drive, so for many people it would probably be easier to stay in caloric surplus.

Glycine I do suspect was making it directly harder to gain. I was staying in caloric surplus (or so I thought), but couldn’t gain at all.

Currently doing a test cycle to get to my target weight quicker. Then I will probably start implementing things like acarbose, empagliflozin, glycine, and isoleucine restriction more regularly. I think I could still maintain on some combination of those, whereas gaining on them would be almost impossible.

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#197

Why do you suspect glycine made it harder for you to gain? It’s a big component of collagen peptides.

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#198

@LVareilles Perhaps because it offsets some of the methionine impact (good for longevity, but less good for bulking?)

#199

As usual, observational studies are useful for hypotheses generation, but little else (IMO). Confounding variables are the biggest culprit.

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#200

There was some discussion above on when to take, and the answer seems to be “with food”.

But why? What is happening, pharmacologically, when acarbose is digested?

Is taking it 15 minutes, an hour, or two hours in advice of / after eating food WAY worse, or just like… 15% worse?

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#201

100mg in the morning (no breakfast, without food)
100mg in the evening (at dinner time, with food)

Doing 1 meal a day.

#202

What’s the purpose of taking Acarbose without food?

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#203

@macneu2299 see for example (click each link to get correct formatting):

And

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#204

None. It’s not absorbed into your body. It’s an alpha-glucosidase inhibitor which means it inhibits the enzyme that breaks down the complex carbs into monosaccharides like glucose so it’s only useful if you eat complex carbs. It does not do anything on simple sugars like glucose or even some carbs like lactose for instance.

When you eat carbs along with acarbose, they are not broken down into glucose so they are passed to the bacteria in your gut that can feed on them (hence the gaz potentially).
A simplified view is that this has basically transformed the regulars carbs like starch into soluble fibers.

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