Acarbose, miglitol, voglibose
Competitively and reversibly inhibit alpha glucosidase brush border hydrolase enzyme- makes postprandial decrease in carbohydrate absorption since complex polysaccharides not broken down into absorbable monosaccharides. Does not affect lactose absorption
Taken with first bite of each meal
Since limited absorption, stays in gut and side effects mostly GI- bloating, gas, diarrhea
acarbose- can cause transaminitis/ liver inj
Contraindications- cirrhosis, IBD, malabsorption syndrome
Do not cause hypoglycemia when used as monotherapy
If hypoglycemic- sucrose/ table sugar will not work- use glucose- PO or IV
Since minimal absorption- systemic toxicity from OD unlikely
acarbose- can cause transaminitis/ liver inj
If hypoglycemic- sucrose/ table sugar will not work- use glucose- PO or IV
Diabetes medications
CHF medications
Diabetes mellitus 
Tono-Pen use
Hypertension 
Drugs of abuse
Intravenous drug use
Metformin