Which of the following antidiabetic medication works by inhibiting carbohydrate breakdown?

Acarbose is classified as an alpha-glucosidase inhibitor. Its mechanism of action involves the competitive and reversible inhibition of pancreatic alpha-amylase and membrane-bound intestinal alpha-glucosidase hydrolase enzymes. These enzymes are essential for the digestion of complex carbohydrates, such as starch and sucrose, into absorbable monosaccharides like glucose. By inhibiting these enzymes, acarbose delays the breakdown and subsequent absorption of carbohydrates from the small intestine, which in turn blunts the postprandial increase in blood glucose levels.

B. Metformin primarily decreases hepatic glucose production and intestinal glucose absorption, while also improving peripheral insulin sensitivity. It does not inhibit carbohydrate breakdown.
C. Dapagliflozin is an SGLT2 inhibitor that works in the kidneys to block glucose reabsorption, thereby increasing urinary glucose excretion.
D. Pioglitazone is a thiazolidinedione that acts as a PPAR-γ agonist to increase insulin sensitivity in adipose tissue, skeletal muscle, and the liver.
E. Sitagliptin is a DPP-4 inhibitor that prevents the breakdown of incretin hormones, leading to increased insulin secretion and suppressed glucagon release.

1. Brunton

L. L.

Hilal-Dandan

R.

& Knollmann

B. C. (Eds.). (2018). Goodman & Gilman's The Pharmacological Basis of Therapeutics (13th ed.). McGraw-Hill Education. Chapter 47: Agents That Affect Blood Glucose

Section: "Alpha-Glucosidase Inhibitors."

2. University of Michigan Medical School. (n.d.). Pharmacology of Drugs for Diabetes Mellitus. Endocrine Pharmacology (Pharm 626) Course Materials. Section on "Alpha-glucosidase inhibitors."

3. Scheen

A. J. (2003). Clinical Pharmacology of Acarbose. Diabetes & Metabolism

29(4 Pt 2)

4S73-4S78. https://doi.org/10.1016/s1262-3636(03)72785-8 (See Abstract and Introduction section for mechanism).