A patient with type 2 diabetes on metformin and glimepiride has HbA1c of 8.8% and postprandial glucose excursions of 280 mg/dL. Acarbose is added. The glucose-lowering effect of acarbose is primarily due to inhibition of which enzyme?
- A Alpha-glucosidase on the brush border of the small intestine ✓
- B Alpha-amylase in pancreatic secretions
- C SGLT1 transporter in the proximal small intestine
- D Dipeptidyl peptidase-4 in the intestinal endothelium
Correct answer: A. Alpha-glucosidase on the brush border of the small intestine
Explanation
Acarbose is an alpha-glucosidase inhibitor that delays carbohydrate digestion at the intestinal brush border, reducing postprandial glucose peaks. It does not inhibit pancreatic alpha-amylase as its primary target (B). SGLT1 inhibition (C) is not its mechanism. DPP-4 inhibition (D) is the action of gliptins.
Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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