It can be used with metformin. Repaglinide, similar to the sulfonylureas, can cause hypoglycemia. Miglitol is an alpha-glucosidase inhibitor similar to acarbose. Both decrease the rate at which complex carbohydrates can be digested and absorbed. By itself, it cannot cause hypoglycemia but when used in conjunction with other agents, can enhance their hypoglycemic potential.
Unabsorbed carbohydrates can cause abdominal pain, flatulence and diarrhea.
These are the principle side effects of miglitol. Thus, it is not the insulin of choice for individuals who adjust insulin dosage based upon fingerstick blood glucose levels. Metformin is on the McKinley capitated formulary.