Which postprandial hyperglycemia management agent among the following is commonly used?

• A. Acarbose
• B. Metformin
• C. SGLT2 inhibitors
• D. DPP-4 inhibitors

Answer: (A)

Target postprandial glucose spikes by slowing carbohydrate absorption after a meal. Acarbose works by inhibiting intestinal alpha-glucosidases, enzymes that break down complex carbohydrates into glucose. When these enzymes are blocked, carbohydrate digestion is slowed, so the rise in blood glucose after a meal is blunted and the post-meal peak is lower. This direct mechanism makes it a commonly used option specifically for postprandial hyperglycemia. In contrast, metformin mainly lowers fasting glucose by reducing hepatic glucose production and improving insulin sensitivity, with less focus on the meal-time rise. SGLT2 inhibitors promote glucose loss in the urine, reducing overall glucose but not specifically delaying meal absorption. DPP-4 inhibitors enhance incretin action to boost insulin secretion after meals, helping postprandial control but not by delaying carbohydrate absorption. Because of its direct meal-time effect, acarbose is the best fit for addressing postprandial hyperglycemia among these options.