Do alpha-glucosidase inhibitors carry a risk of hypoglycemia when used as monotherapy?

• A. True
• B. False
• C. Only in elderly
• D. Only with other antidiabetic agents

Answer: (B)

Alpha-glucosidase inhibitors work by slowing the digestion of carbohydrates in the small intestine, which reduces the post-meal rise in blood glucose without stimulating the pancreas to release more insulin. Because they don’t increase insulin levels, they don’t by themselves create the imbalance that leads to hypoglycemia. Hypoglycemia with these drugs would only happen if another glucose-lowering medication is also used, or in situations of very low caloric intake. If hypoglycemia does occur in that context, treat it with glucose (dextrose) rather than relying on carbohydrate foods that require intestinal digestion, which the inhibitor can delay. So, as monotherapy, the risk of hypoglycemia is not a concern.