Are the effects of α-glucosidase inhibitors on cardiovascular events related to elevated levels of hydrogen gas in the gastrointestinal tract?

The major side-effect of treatment with α-glucosidase inhibitors, flatulence, occurs when undigested carbohydrates are fermented by colonic bacteria, resulting in gas formation. We propose that the cardiovascular benefits of α-glucosidase inhibitors are partly attributable to their ability to neutralise oxidative stress via increased production of H2 in the gastrointestinal tract. Acarbose, which is an α-glucosidase inhibitor, markedly increased H2 production, with a weaker effect on methane production. Our hypothesis is based on our recent discovery that H2 acts as a unique antioxidant, and that when inhaled or taken orally as H2-dissolved water it ameliorates ischaemia–reperfusion injury and atherosclerosis development.