May 23 2022



Active ingredient: acarbose

It has not been reported significant interactions between acarbose and ethyl alcohol. However, it should be remembered that the drug is indicated for the treatment of diabetes mellitus, a circumstance that determines the limits of a possible alcohol consumption.

Alcohol influences the metabolism of glucose of both diabetic as not diabetic patients. Since alcohol inhibits gluconeogenesis (formation of glucose) and glycogenolysis (breakdown of glycogen to release glucose), acute alcohol ingestion without food can cause hypoglycemia, especially in patients with the glycogen stores depleted and/or in combination with oral antidiabetic drugs[1].

Alcohol increases postprandial glucose elevation probably through impaired insulin sensitivity[2], which can precisely counter the effect of acarbose.

A high alcohol consumption increases the risk of abnormal glucose regulation in males. In women, the association is more complex: a decreased risk of hyperglycemia with medium or low consumption and high risk with high consumption [3].

Excessive alcohol consumption is also associated with an increased risk of metabolic syndrome in men with diabetes [4]. Not only a heavy alcohol consumption but also a moderate consumption relates to a higher incidence of elevated fasting glucose or diabetes in obese men [5].

Complete cessation of alcohol consumption should be set before taking a dose adjustment in situations where there is not a good control of blood glucose using oral antidiabetic agents [6].

Consuming large amounts of ethanol can cause ketoacidosis, hypertriglyceridemia, and if taken out of meals, can cause hypoglycemia and ultimately increased risk of death from non-cardiovascular causes [7].

References:

1: van de Wiel A. Diabetes mellitus and alcohol. Diabetes Metab Res Rev. 2004 Jul-Aug;20(4):263-7.
2: H?t?nen KA, Virtamo J, Eriksson JG, Per?l? MM, Sinkko HK, Leivisk? J, Valsta LM. Modifying effects of alcohol on the postprandial glucose and insulin responses in healthy subjects. Am J Clin Nutr. 2012 Jul;96(1):44-9.
3: Cullmann M, Hilding A, ?stenson CG.. Alcohol consumption and risk of pre-diabetes and type 2 diabetes development in a Swedish population. Diabet Med. 2012 Apr;29(4):441-52.
4: Wakabayashi I. Association between alcohol drinking and metabolic syndrome in Japanese male workers with diabetes mellitus. J Atheroscler Thromb. 2011;18(8):684-92.
5: Roh WG, Shin HC, Choi JH, Lee YJ, Kim K. Alcohol consumption and higher incidence of impaired fasting glucose or type 2 diabetes in obese Korean men. Alcohol. 2009 Dec;43(8):643-8.
6: Tsai CS, Oke TO, Tam CW, Olubadewo JO, Ochillo RF. The effect of regular alcohol use on the management of non-insulin diabetes mellitus. Cell Mol Biol (Noisy-le-grand). 2003 Dec;49(8):1327-32.
7: Swade TF, Emanuele NV. Alcohol & diabetes. Compr Ther. 1997 Feb;23(2):135-40.