After wearing a CGM, I’m actually finding my glucose levels are quite low, typically in the high 4s to low 5s. My question is then why do all my blood tests report a HBA1C in the 5.4-5.9 range??? I’m not sure what to believe!
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How sure are you that your CGM gives accurate readings? I’m not saying one way or another, but my experience of the Abbot OTC CGM has been utterly unacceptable. I cross-checked the validity of those readings with a simultaneous three way tests, and while fingerprick glucose monitor and the vein blood test results had good agreement, the CGM was ludicrously off scale so absurdly, that my confidence in any of these CGM readings is exactly zero.
Now, maybe your CGM works better for you, I wouldn’t doubt it. But it might be interesting for you to try to check it against the gold standard of vein serum and finger glucose monitor, so you might have an idea about possible margin of error.
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Same experience here → make sense to validate with fingerpricks…
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Should healthy people take both acarbose and an SGLT2 inhibitor or is that too much glucose inhibition? Any preference for one over the other?
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I take both, and without the acarbose, I still get glucose spikes. So, I’d say that both are important.
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There are no “shoulds” in this area. We are all looking at the data on both compounds and making personal decisions based on our own risk reward profiles, and reading of the data.
Different people’s bodies respond differently to acarbose; partly based on diet type. Gas is a common issue, that can go away with time and avoidance of a diet based on wheat-oriented carbs.
I would say the data is currently better on SGLT2 inhibitors as they are newer drugs and a lot more research is ongoing on these drugs, and looks very promising. Acarbose is an old drug that is no longer researched much, or even sold much in the western world.
I alternate between acarbose and empagliflozin… both work well for me in terms of lowering blood glucose spikes. I would recommend tracking blood sugar levels if you try either of these, and see how your body responds to both of them.
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Thank you both. I ask in part because there seems to be a lot of confusion in the other thread about whether SGLT2 inhibitors actually prevent glucose spikes after eating. Guess the only way to know for yourself is to test. FWIW here’s what consensus says:
Yes, empagliflozin helps prevent glucose spikes after eating by lowering postprandial (after-meal) glucose levels and reducing overall glucose variability.
Evidence:
- Reduced Postprandial Glucose and Glucose Variability: A 4-week randomized, placebo-controlled trial in Japanese patients with type 2 diabetes found that empagliflozin significantly lowered postprandial glucose levels and reduced 24-hour glucose variability (Nishimura et al., 2015).
- Improved Postprandial Glucose in Type 1 Diabetes: In a study with patients with type 1 diabetes using continuous glucose monitoring, empagliflozin reduced glucose exposure, postprandial glucose excursions, and variability, and increased time spent in the target glucose range (Famulla et al., 2017).
- Positive Effects in Pancreatectomized Patients: Even in patients without a pancreas, empagliflozin improved postprandial glucose control after a mixed meal test, suggesting its effects are independent of insulin secretion (Baekdal et al., 2023).
- General Glucose Lowering Effects: Reviews and trials also highlight that empagliflozin consistently reduces both fasting and postprandial glucose levels as part of its glucose-lowering mechanism, through urinary glucose excretion (Scheen, 2015).
Conclusion:
Empagliflozin effectively prevents glucose spikes after meals by lowering postprandial glucose and reducing overall glucose variability, making it a useful tool in managing blood sugar levels.
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Beth
#575
I’ve used Metformin alone, I then added acarbose, and then I later dropped metformin and added dapagliflozin. According to my cgm, dapagliflozin definitely helps control my glucose spikes.
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RapAdmin
split this topic
#576
9 posts were merged into an existing topic: Canagliflozin - Another Top Longevity Drug
This is in diabetic people (or even more extreme, patients without a pancreas). I.e. people with advanced, pathogenic insulin resistance.
Our demographic of otherwise healthy people with “normal” glucose and insulin handling is quite different.
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I’ve never worn a CGM, but I have a similar issue. My fasting glucose and insulin levels are always near the bottom of the range. I forget what my insulin is, but my fasting glucose always comes back no higher than mid 70s, but my hba1c is about 5.3. My diet isn’t that bad.
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I dont mind the farting, but there are times when it actually breaks up your sleep at night with the tank of gas… its something when your half asleep in a dozed state and you waking up constantly farting… it happens on occasion.
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If acarbose is good due to inhibiting alpha-galactosidase, does that mean that digestive enzyme supplements containing alpha-galactosidase are bad?
I keep them on hand in case I get a stomach upset, they seem to solve all issues relating to stomach pain, nausea, etc. I used to take them a bit more often with meals hoping to maximize nutrient uptake from them but since I learned about acarbose a couple of years ago I held back using them.
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LukeMV
#585
Not for me, but I’ve been taking it essentially as soon as the ITP results came out so my body had adjusted. At first, kind of yes.
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LukeMV
#586
Any more updates on your high dose Acarbose experiment?
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LukeMV
#587
I take 50mg with each of my four daily meals. I had my glucose checked 3 hours after a healthy breakfast that included Acarbose and it was 67. My glucose seems to be lower a couple hours after meals than fasted in the morning
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Ongoing… This is the issue with taking a lot of substances at the same time… I was taking a lot of grams of glycine during my experiment with higher acarbose rates which I believe, along with the acarbose and jardiance lowers glucose… I stopped taking glycine while still taking jardiance 25 and 600 mg of acarbose (300, twice daily with or without food), and wasnt near hypoglycemia. The one on the line hypoglycemic reading I got was jardiance 25, acarbose 700 a day (twice 350 with to without food) and a lot of grams of glycine with my coffee… I’m in limbo with whether or not I want to continue with glycine. If I stop taking it I will probably go even higher than the 600 daily (300 twice daily with or without food) acarbose, maybe towards 1000. If I continue with the glycine, I will probably stop at 600 (twice daily with or without food) acarbose with jardiance 25.
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59vw
#589
Maybe you’ve found some data on dose range for acarbose? I’ll admit I haven’t looked but there definitely will be an upper limit where you will not get any more serum glucose reduction as you increase the Acarbose dose. If I had to guess I’d think it would be down around 100-200 mg / meal.
Do you see a clear difference in glucose spikes between an acarbose dose of 100 /meal and a dose of 300 / meal? I guess if the meal is high in carbohydrates one might see an affect but then IMO a better approach would be to cut down on the carbs rather than take more acarbose.
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Starting Aug 2024(the conversation), I think thats what was in the itp(?) tests equivalent human dosage. Around 800? I’m a big man a 200 pounds so I would take a bit more
LukeMV
#591
I’m quoting this again despite being two months old but this is so helpful to see. It shows that 50mg per meal could be enough and that we don’t need veery big doses like the ITP used.
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