Key takeaways
Acarbose (Precose) and Actos (pioglitazone) are both medications used to help control blood sugar in people with type 2 diabetes, but they work in different ways and have different side effects. Acarbose is an alpha-glucosidase inhibitor that slows down the digestion of carbohydrates in your gut, leading to lower blood sugar levels after meals. It is taken three times a day with the first bite of each main meal and is available only as a generic. Actos, on the other hand, is a thiazolidinedione that improves your body's ability to use insulin and is taken once daily, with or without food. Actos can take several weeks to show its full effect and is available under the brand name Actos. Acarbose is less likely to cause hypoglycemia when used alone but can cause side effects like gas and diarrhea. Actos rarely causes dangerously low blood sugar on its own but can lead to weight gain, fluid build-up, and an increased risk of bladder cancer and bone fractures. Both medications can be used with other diabetes treatments like metformin, but they are not typically first-choice options.
