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Acarbose improved severe postprandial hypotension in a patient with diabetes mellitus.
J Diabetes Complications. 2001 May-Jun; 15(3):158-61.JD

Abstract

Postprandial hypotension (PPH) is defined as a decrease of systolic blood pressure by more than 20 mmHg after meals. Severe PPH is a troublesome diabetic complication, which has no established means of treatment. We encountered a patient who had diabetes mellitus complicated by severe PPH and attempted to treat this problem using several medications (octreotide, midodrine hydrochloride, and acarbose). A 58-year-old male with diabetic triopathy complained of orthostatic dizziness and vertigo after meals. The blood pressure was monitored for 24 h with an ambulatory blood pressure monitor, revealing that the systolic blood pressure decreased markedly after breakfast and dinner by 45 and 50 mmHg, respectively. PPH was not improved by a subcutaneous injection of octreotide. Administration of midodrine hydrochloride reduced the frequency of hypotensive episodes from twice to once daily, but the magnitude of the postprandial fall in blood pressure was still around 30 mmHg. After the patient started to receive acarbose therapy, the postprandial fall in blood pressure was diminished to 18 mmHg and his symptoms largely disappeared. For the treatment of PPH in diabetic patients, our experience suggests that it may be appropriate to try first on alpha-glucosidase inhibitor like acarbose.

Authors+Show Affiliations

First Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-city, Osaka, 569-8686, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11358685

Citation

Sasaki, E, et al. "Acarbose Improved Severe Postprandial Hypotension in a Patient With Diabetes Mellitus." Journal of Diabetes and Its Complications, vol. 15, no. 3, 2001, pp. 158-61.
Sasaki E, Goda K, Nagata K, et al. Acarbose improved severe postprandial hypotension in a patient with diabetes mellitus. J Diabetes Complications. 2001;15(3):158-61.
Sasaki, E., Goda, K., Nagata, K., Kitaoka, H., Ohsawa, N., & Hanafusa, T. (2001). Acarbose improved severe postprandial hypotension in a patient with diabetes mellitus. Journal of Diabetes and Its Complications, 15(3), 158-61.
Sasaki E, et al. Acarbose Improved Severe Postprandial Hypotension in a Patient With Diabetes Mellitus. J Diabetes Complications. 2001 May-Jun;15(3):158-61. PubMed PMID: 11358685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acarbose improved severe postprandial hypotension in a patient with diabetes mellitus. AU - Sasaki,E, AU - Goda,K, AU - Nagata,K, AU - Kitaoka,H, AU - Ohsawa,N, AU - Hanafusa,T, PY - 2001/5/19/pubmed PY - 2001/8/10/medline PY - 2001/5/19/entrez SP - 158 EP - 61 JF - Journal of diabetes and its complications JO - J Diabetes Complications VL - 15 IS - 3 N2 - Postprandial hypotension (PPH) is defined as a decrease of systolic blood pressure by more than 20 mmHg after meals. Severe PPH is a troublesome diabetic complication, which has no established means of treatment. We encountered a patient who had diabetes mellitus complicated by severe PPH and attempted to treat this problem using several medications (octreotide, midodrine hydrochloride, and acarbose). A 58-year-old male with diabetic triopathy complained of orthostatic dizziness and vertigo after meals. The blood pressure was monitored for 24 h with an ambulatory blood pressure monitor, revealing that the systolic blood pressure decreased markedly after breakfast and dinner by 45 and 50 mmHg, respectively. PPH was not improved by a subcutaneous injection of octreotide. Administration of midodrine hydrochloride reduced the frequency of hypotensive episodes from twice to once daily, but the magnitude of the postprandial fall in blood pressure was still around 30 mmHg. After the patient started to receive acarbose therapy, the postprandial fall in blood pressure was diminished to 18 mmHg and his symptoms largely disappeared. For the treatment of PPH in diabetic patients, our experience suggests that it may be appropriate to try first on alpha-glucosidase inhibitor like acarbose. SN - 1056-8727 UR - https://www.unboundmedicine.com/medline/citation/11358685/Acarbose_improved_severe_postprandial_hypotension_in_a_patient_with_diabetes_mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1056-8727(01)00138-6 DB - PRIME DP - Unbound Medicine ER -