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Letter to the Editor| Volume 11, ISSUE 5, P377-378, June 2010

Preventive Treatment With Acarbose in Diabetic Reactive Hypoglycemia

DOI:https://doi.org/10.1016/j.jamda.2010.02.018
Preventive Treatment With Acarbose in Diabetic Reactive Hypoglycemia
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      Acarbose primarily inhibits α-glucosidase enzymes and diminishes and slows down the intestinal carbohydrate breakdown for absorption from polysaccharides to disaccharides and from disaccharides to monosaccharide.
      • Lee A.
      Management of elderly diabetic patients in the subacute care setting.
      Clin Geriatr Med. 2000; 16: 833-852
      , 
      • Mazza A.D.
      • Morley J.E.
      Update on diabetes in the elderly and the application of current therapeutics.
      J Am Med Dir Assoc. 2007; 8: 489-492
      Case reports and double-blinded clinical trials have shown acarbose is effective in preventing postprandial hypoglycemia in patients with reactive hypoglycemia
      • Imhof A.
      • Schneemann M.
      • Schaffner A.
      • Brundle M.
      Reactive hypoglycemia due to late dumping syndrome: Successful treatment with acarbose.
      Swiss Med Wkly. 2001; 131: 81-83
      , 
      • Speth P.A.J.
      • Jansen J.B.M.J.
      • Lamers C.B.H.W.
      Effect of acarbose, pectin, a combination of acarbose with pectin, and placebo on postprandial reactive hypoglycemia after gastric surgery.
      Gut. 1983; 24: 798-802
      , 
      • Gerard J.
      • Luyckx A.S.
      • Lefebvre P.J.
      Acarbose in reactive hypoglycemia: A double-blind study.
      Int J Clin Pharmacol Ther Toxicol. 1984; 22: 25-31
      with most cases being after gastric surgery. Thus far, there has been only one case report
      • Imhof A.
      • Schneemann M.
      • Schaffner A.
      • Brundle M.
      Reactive hypoglycemia due to late dumping syndrome: Successful treatment with acarbose.
      Swiss Med Wkly. 2001; 131: 81-83
      published on the use of acarbose that examined the relation between GLP-1 secretion and insulin-glucose dynamics. It showed
      • Imhof A.
      • Schneemann M.
      • Schaffner A.
      • Brundle M.
      Reactive hypoglycemia due to late dumping syndrome: Successful treatment with acarbose.
      Swiss Med Wkly. 2001; 131: 81-83
      an increase in the glucose nadir when ingesting sucrose with acarbose, with postprandial glucose and insulin peaks being blunted and parallel reductions in GLP-1 responses.
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      References

        • Lee A.
        Management of elderly diabetic patients in the subacute care setting.
        Clin Geriatr Med. 2000; 16: 833-852
        View in Article
        • Mazza A.D.
        • Morley J.E.
        Update on diabetes in the elderly and the application of current therapeutics.
        J Am Med Dir Assoc. 2007; 8: 489-492
        View in Article
        • Imhof A.
        • Schneemann M.
        • Schaffner A.
        • Brundle M.
        Reactive hypoglycemia due to late dumping syndrome: Successful treatment with acarbose.
        Swiss Med Wkly. 2001; 131: 81-83
        View in Article
        • Speth P.A.J.
        • Jansen J.B.M.J.
        • Lamers C.B.H.W.
        Effect of acarbose, pectin, a combination of acarbose with pectin, and placebo on postprandial reactive hypoglycemia after gastric surgery.
        Gut. 1983; 24: 798-802
        View in Article
        • Gerard J.
        • Luyckx A.S.
        • Lefebvre P.J.
        Acarbose in reactive hypoglycemia: A double-blind study.
        Int J Clin Pharmacol Ther Toxicol. 1984; 22: 25-31
        View in Article
        • Góke B.
        • Fuder H.
        • Wieckhorst G.
        • et al.
        Voglibose (AO-128) is an efficient α-glucosidase inhibitor and mobilizes the endogenous GLP-1 reserve.
        Digestion. 1995; 56: 493-501
        View in Article
        • Seifarth C.
        • Bergmann J.
        • Nauck M.A.
        • et al.
        Prolonged and enhanced secretion of glucagon-like peptide 1 (7–36 amide) after oral sucrose due to α-glucosidase inhibition (acarbose) in type 2 diabetic patients.
        Diabet Med. 1998; 15: 485-491
        View in Article
        • Lee A.
        • Patrick P.
        • Wishart J.
        • et al.
        The effects of miglitol on glucagon-like peptide-1 secretion and appetite sensations in obese type 2 diabetics.
        Diabetes Obes Metab. 2002; 4: 329-335
        View in Article

      Article info

      Identification

      DOI: https://doi.org/10.1016/j.jamda.2010.02.018

      Copyright

      © 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

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