Acarbose

The lifespan results are in mice. In the Interventions Testing Program, acarbose raised median lifespan by 22% in male mice and 5% in females [1], and a repeat study at three doses confirmed a larger effect in males [2].

In people, the trials are in prediabetes and heart disease, not healthy aging. In STOP-NIDDM, acarbose cut the rate of new diabetes by a quarter in adults with impaired glucose tolerance [3], and a secondary analysis reported fewer cardiovascular events, based on a small number of them [4]. The much larger ACE trial in 6,522 Chinese patients with coronary heart disease found no reduction in cardiovascular events, though diabetes was again less common [5].

Acarbose is approved to treat type 2 diabetes, where it lowers HbA1c by about 0.8 percentage points [6]. Whether it slows aging or extends life in people without diabetes is unknown.

• Acarbose is a prescription drug approved for type 2 diabetes. Taking it to slow aging is off-label and unproven.
• Gas, bloating and diarrhea are common and are the main reason people stop it; in STOP-NIDDM almost a third of the acarbose group stopped early.
• It is not for people with inflammatory bowel disease, bowel obstruction or severe kidney or liver disease. High doses can raise liver enzymes.
• On its own it rarely causes low blood sugar, but with insulin or sulfonylureas a low must be treated with glucose, not table sugar.
• Any use belongs with a physician who checks blood work.