Pharmacology · Class
Other glucose-lowering drugs !
Smaller groups for type 2 (and type 1) diabetes: drugs that slow carbohydrate digestion, short-acting insulin secretagogues and an amylin analogue.
Updated 2026-11-01
What they are
Alpha-glucosidase inhibitors (acarbose), meglitinides (repaglinide) and amylin analogues (pramlintide). Each targets mainly the glucose rise after meals.
Mechanism of action
Acarbose blocks the brush-border alpha-glucosidases that split starch and sucrose, so carbohydrate is absorbed later and more slowly. Repaglinide closes the beta-cell KATP channel like a sulfonylurea but at a different site of SUR1, with a quick, short action around meals. Pramlintide copies amylin, a beta-cell hormone that slows gastric emptying, reduces glucagon after meals and increases fullness.
Target: Intestinal alpha-glucosidases, SUR1 of the KATP channel, amylin receptors
Drugs in this class
- AcarboseAn oral drug that slows carbohydrate digestion in the gut, so glucose rises less after meals. Flatulence is the usual…Intestinal alpha-glucosidases (maltase-glucoamylase, sucrase-isomaltase) and pancreatic alpha-amylase
- RepaglinideA short-acting meglitinide taken just before meals: it gives a quick burst of insulin. Never combined with gemfibrozil.Sulfonylurea receptor 1 (SUR1) of the KATP channel
- PramlintideAn injected copy of amylin, a beta-cell hormone, used with mealtime insulin. It can cause severe hypoglycemia in the…Amylin receptors (calcitonin receptor with RAMP proteins)
Others in the class
- miglitol (alpha-glucosidase inhibitor)
- nateglinide (meglitinide)
- voglibose
Test yourself
Think of the answer, then tap the question to see it.
Why is table sugar a poor treatment for hypoglycemia in a patient on acarbose?
Sucrose must be split by intestinal alpha-glucosidases before absorption, and acarbose blocks them; glucose is absorbed directly.
How does repaglinide differ from a sulfonylurea?
Both close the beta-cell KATP channel, but repaglinide is not a sulfonylurea, binds a different site and acts quickly and briefly, so it is given with meals.
Which hormone does pramlintide copy, and which cell normally makes it?
Amylin, released by the pancreatic beta cell together with insulin.
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - ACARBOSE tablet (DailyMed (U.S. National Library of Medicine), 2026); DailyMed - REPAGLINIDE tablet (DailyMed (U.S. National Library of Medicine), 2026); Pramlintide Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026).
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Representative model, for educational purposes only.