Which medications can lower postprandial blood glucose?

Under normal circumstances, postprandial blood glucose elevation is primarily due to carbohydrates in food being broken down into glucose. Insufficient insulin secretion or impaired insulin function leads to abnormal regulation of blood glucose levels. Prolonged elevation may trigger various complications. Patients may take medications such as acarbose tablets, repaglinide tablets, nateglinide tablets, vildagliptin tablets, and empagliflozin tablets as directed by a physician. Detailed explanations are as follows:

1. Acarbose Tablets

Acarbose inhibits α-glucosidase in the brush border of the small intestinal mucosa, delays the breakdown of carbohydrates into glucose, reduces glucose absorption, and thus lowers the postprandial blood glucose peak. It is suitable for individuals whose postprandial hyperglycemia is primarily due to consumption of carbohydrate-rich meals.

2. Repaglinide Tablets

Repaglinide belongs to the non-sulfonylurea class of insulin secretagogues. It stimulates pancreatic β-cells to rapidly secrete insulin after meals, aligning with the timing of postprandial blood glucose elevation. It effectively lowers postprandial glucose levels and is suitable for postprandial glycemic control in patients with type 2 diabetes, especially those with significant postprandial glucose fluctuations.

3. Nateglinide Tablets

Nateglinide is also a non-sulfonylurea insulin secretagogue. It promotes insulin release by closing potassium channels on the membrane of pancreatic β-cells. It acts rapidly and has a short duration of action, enabling precise reduction of postprandial blood glucose. It is suitable for patients with marked postprandial hyperglycemia who require flexibility in meal timing.

4. Vildagliptin Tablets

Vildagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that inhibits the degradation of GLP-1 and GIP in the body, prolonging their effects, promoting insulin secretion, and suppressing glucagon release, thereby lowering postprandial blood glucose. It is suitable for glycemic control in patients with type 2 diabetes, especially those at risk of cardiovascular disease.

5. Empagliflozin Tablets

Empagliflozin belongs to the sodium-glucose co-transporter 2 (SGLT2) inhibitor class. It lowers postprandial blood glucose by inhibiting renal reabsorption of glucose, thereby increasing urinary glucose excretion. It also has weight-reducing and blood pressure-lowering effects. It is suitable for patients with type 2 diabetes, especially those with obesity or cardiovascular disease.

Maintaining healthy lifestyle habits is important, including controlling staple food intake, reducing refined carbohydrates, increasing dietary fiber consumption, engaging in light physical activity such as walking after meals, and avoiding prolonged sitting. These measures can help assist in lowering postprandial blood glucose levels.