Intervention
Acarbose
Last updated Sun May 17 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
What it is
Acarbose blocks α-glucosidase enzymes in the small intestine, slowing the breakdown of complex carbohydrates and reducing post-prandial glucose spikes. It is approved for type-2 diabetes management.
Why it’s of interest
In the NIA Interventions Testing Program, acarbose extended lifespan in genetically heterogeneous mice across three sites, with larger effects in males. Effects appeared even when started in late life.
Mechanism
- Lower post-prandial glucose → less glycation, less insulin secretion.
- Shifts carbohydrate delivery to the colon, altering microbiome composition (more SCFA-producing taxa).
- Possibly mimics aspects of caloric restriction without restricting calories.
Human evidence
- Effective for glycaemic control in T2D, particularly post-prandial glucose.
- STOP-NIDDM trial reduced progression to T2D and reduced cardiovascular events in impaired glucose tolerance.
- No longevity outcome trials in non-diabetics.
Safety
Main side effects are gastrointestinal: flatulence and diarrhoea (from undigested carbohydrate reaching the colon). Tend to decrease over weeks of use. Severe hepatotoxicity rare. Hypoglycaemia, when combined with insulin/sulfonylureas, must be treated with glucose (not sucrose), as sucrose breakdown is also inhibited.
Related entries
References
- Harrison, D. E. et al. Acarbose, 17-α-estradiol, and nordihydroguaiaretic acid extend mouse lifespan preferentially in males. Aging Cell 13, 273–282 (2014).