Acarbose — Alpha-glucosidase inhibitor (AGI) — FDA-approved antidiabetic agent with ITP-confirmed longevity activity

Acarbose is a pseudo-tetrasaccharide that competitively inhibits intestinal alpha-glucosidases (maltase, sucrase, glucoamylase, glucan-1,4-alpha-glucosidase) and pancreatic alpha-amylase. This delays and reduces the breakdown and absorption of dietary complex carbohydrates, blunting postprandial glucose spikes without increasing insulin secretion. Longevity mechanisms: (1) NIA Interventions Testing Program (ITP) — one of the most reproducible mouse longevity interventions: significant lifespan extension in male mice (+22% median lifespan in males, +5% in females in 3 independent sites); female benefit attenuated because mice consume more food due to acarbose's caloric restriction-like intestinal effect; (2) Caloric restriction mimetic mechanism — by reducing postprandial glucose, acarbose reduces AGE formation, insulin/IGF-1 signaling, and activates AMPK; (3) Gut microbiome modulation — increases production of short-chain fatty acids (propionate, butyrate) via fermentation of unabsorbed carbohydrates; (4) Reduces postprandial insulin spikes, which may extend AMPK activation periods between meals.