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 H 2 in the gastrointestinal tract. Acarbose, which is an α ‐glucosidase inhibitor, markedly increased H 2 production, with a weaker effect on methane production. Our hypothesis is based on our recent discovery that H 2 acts as a unique antioxidant, and that when inhaled or taken orally as H 2 ‐dissolved water it ameliorates ischaemia–reperfusion injury and atherosclerosis development.