sulfonylurea + α-glucosidase inhibitor

**Sulfonylurea + α-glucosidase inhibitor** is a combination therapy used primarily for the management of type 2 diabetes mellitus. This combination typically involves a representative from each class (such as glibenclamide or gliclazide for sulfonylureas, and acarbose or voglibose for α-glucosidase inhibitors), but the exact agents may vary. - **Mechanism of action:** - **Sulfonylureas** stimulate insulin secretion by binding to and inhibiting ATP-sensitive potassium channels on pancreatic beta cells, leading to cell depolarization, calcium influx, and subsequently, insulin release[2][5]. - **α-Glucosidase inhibitors** act locally within the gastrointestinal tract by competitively inhibiting enzymes in the intestinal brush border (primarily glucoamylase, sucrase, maltase, and isomaltase). This delays carbohydrate breakdown and absorption, leading to reduced postprandial glucose excursions[4][6]. - **Clinical use:** The combination is typically prescribed when monotherapy does not achieve adequate glycemic control. Clinical trials demonstrate the combination improves both fasting and postprandial glucose, and can prolong the duration of good glycemic control versus sulfonylurea alone in patients with type 2 diabetes[1][3]. - **Risks:** While hypoglycemia risk is low with α-glucosidase inhibitor monotherapy, combination with sulfonylurea increases the risk of hypoglycemia[4][6].