How are alpha-glucosidase inhibitors administered?

• A. On an empty stomach
• B. With the first bite of main meals (TID)
• C. Immediately after meals
• D. At bedtime

Answer: (B)

Alpha-glucosidase inhibitors work by blocking enzymes in the brush border of the small intestine that digest carbohydrates, so they blunt the rise in blood glucose after meals. Because their effect is to delay carbohydrate digestion as soon as carbs enter the gut, they’re best taken with the first bite of each main meal (three times daily) to align the drug’s action with meal-derived glucose. Taking the medication on an empty stomach would have little effect since there’s no carbohydrate to delay; taking it after a meal misses the opportunity to block digestion early, and taking it at bedtime won’t impact post-meal glucose spikes.