Which medication is most likely causing diarrhea and abdominal pain for the client's sibling?

Acarbose is an alpha-glucosidase inhibitor used to manage blood glucose levels in individuals with type 2 diabetes by slowing down the absorption of carbohydrates in the intestines. This mechanism can lead to gastrointestinal side effects, including diarrhea and abdominal pain.

When carbohydrates are not fully absorbed due to the action of acarbose, they can ferment in the intestines, leading to symptoms such as gas, bloating, and diarrhea. These side effects are particularly common when patients consume a diet high in carbohydrates while on acarbose, as the unabsorbed carbohydrates can result in increased osmotic load in the colon, thus causing diarrhea.

The other medications listed have different mechanisms of action and are associated with varying side effects. Metformin, for example, may also cause gastrointestinal upset but is more commonly linked to nausea and less frequent diarrhea compared to acarbose. Insulin primarily works by facilitating glucose uptake and is less likely to cause these specific gastrointestinal symptoms. Glyburide, a sulfonylurea, primarily increases insulin secretion rather than affecting carbohydrate absorption and is not typically associated with diarrhea or abdominal pain.

Hence, considering the side effect profile and mechanism of action, acarbose is the medication most likely responsible for the